•J^J/
: .AC '/•/- "
__. -
NORTH CAROLINA
REGISTER
VOLUME 10 • ISSUE 2 • Pages 54 -190
April 17, 1995
IN THIS ISSUE
Executive Orders
Acupuncture Licensing Board
Environment, Health, and Natural Resources
Human Resources
Justice
Labor
List of Rules Codified
Medical Examiners
Real Estate Commission
RRC Objections
Contested Case Decisions
PUBLISHED BY
The Office of Administrative Hearings
Rules Division
PO Drawer 27447
Raleigh, NC 27611- 744 7
Telephone (919) 733-2678
Fax (919) 733-3462
Bag ■*! § fp" ~i \j B» £ 5
E a i; f u^' ^i: J vJ aoakj>
APR 20 1995
KATHRINE R EYERETT
LAW LIBRARY
This publication is printed on permanent, acid-free paper in compliance with G.S. 125-11.13
INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE
NORTH CAROLINA REGISTER
The North Carolina Register is published twice a month and
contains information relating to agency, executive, legislative and
ludicial actions required by or affecting Chapter 150B of the
General Statutes. All proposed administrative rules and notices of
public hearings filed under G.S. 150B-21.2 must be published in
the Register. The Register will typically comprise approximately
fifty pages per issue of legal text.
State law requires that a copy of each issue be provided free of
charge to each county in the state and to various state officials and
institutions.
The North Carolina Register is available by yearly subscription
at a cost of one hundred and twenty dollars ($120.00) for 24
issues. Individual issues may be purchased for ten dollars
($10.00).
Requests for subscription to the North Carolina Register should
be directed to the Office of Administrative Hearings, PO Drawer
27447, Raleigh, NC 27611-7447.
ADOPTION, AMENDMENT, AND REPEAL OF RULES
The following is a generalized statement of the procedures to be
followed for an agency to adopt, amend, or repeal a rule. For the
specific statutory authority, please consult Article 2A of Chapter
150B of the General Statutes.
Any agency intending to adopt, amend, or repeal a rule must
first publish notice of the proposed action in the North Carolina
Register. The notice must include the time and place of the public
hearing (or instructions on how a member of the public may
request a hearing); a statement of procedure for public comments;
the text of the proposed rule or the statement of subject matter; the
reason for the proposed action; a reference to the statutory
authority for the action and the proposed effective date.
Unless a specific statute provides otherwise, at least 15 days
must elapse following publication of the notice in the North
Carolina Register before the agency may conduct the public
hearing and at least 30 days must elapse before the agency can take
action on the proposed rule. An agency may not adopt a rule that
differs substantially from the proposed form published as part of
the public notice, until the adopted version has been published in
the North Carolina Register for an additional 30 day comment
period.
When final action is taken, the promulgating agency must file the
rule with the Rules Review Commission (RRC). After approval
by RRC, the adopted rule is filed with the Office of Administrative
Hearings (OAH).
A rule or amended rule generally becomes effective 5 business
days after the rule is filed with the Office of Administrative
Hearings for publication in the North Carolina Administrative
Code (NCAC).
Proposed action on rules may be withdrawn by the promulgating
agency at any time before final action is taken by the agency or
before filing with OAH for publication in the NCAC.
TEMPORARY RULES
Under certain emergency conditions, agencies may issue
temporary rules. Within 24 hours of submission to OAH, the
Codifier of Rules must review the agency's written statement of
findings of need for the temporary rule pursuant to the provisions
in G.S. 150B-21.1. If the Codifier determines that the findings
meet the criteria in G.S. 150B-21.1, the rule is entered into the
NCAC. If the Codifier determines that the findings do not meet
the criteria, the rule is returned to the agency. The agency may
supplement its findings and resubmit the temporary rule for an
additional review or the agency may respond that it will remain
with its initial position. The Codifier, thereafter, will enter the
rule into the NCAC. A temporary rule becomes effective either
when the Codifier of Rules enters the rule in the Code or on the
sixth business day after the agency resubmits the rule without
change. The temporary rule is in effect for the period specified in
the rule or 180 days, whichever is less. An agency adopting a
temporary rule must begin rule-making procedures on the
permanent rule at the same time the temporary rule is filed with
the Codifier.
NORTH CAROLINA ADMINISTRATIVE CODE
The North Carolina Administrative Code (NCAC) is a
compilation and index of the administrative rules of 25 state
agencies and 40 occupational licensing boards. Compilation and
publication of the NCAC is mandated by G.S. 150B-21.18.
The Code is divided into Tides and Chapters. Each state agency
is assigned a separate title which is further broken down by
chapters. Title 21 is designated for occupational licensing boards.
The NCAC is available in two formats.
(1) Single pages may be obtained at a minimum cost of
two dollars and 50 cents ($2.50) for 10 pages or less,
plus fifteen cents ($0.15) per each additional page.
Requests for pages of rules or volumes of the NCAC
should be directed to the Office of Administrative
Hearings.
(2) The full publication and supplement service is printed
and distributed by Barclays Law Publishers. It is
available in hardcopy, CD-ROM and diskette format.
For subscription information, call 1-800-888-3600.
CITATION TO THE NORTH CAROLINA REGISTER
The North Carolina Register is cited by volume, issue, page
number and date. 10:01 NCR 1-67, April 3, 1995 refers to
Volume 10, Issue 1, pages 1 through 67 of the North Carolina
Register issued on April 3, 1995.
t
FOR INFORMATION CONTACT: Office of Administrative Hearings, ATTN: Rules Division, PO Drawer 27447, Raleigh,
NC 27611-7447, (919) 733-2678, FAX (919) 733-3462.
•
NORTH CAROLINA
IN THIS ISSUE
I. EXECUTIVE ORDERS
Executive Orders 73-74 .
•
Volume 1 O, Issue 2
Pages 54 - 190
April 17, 1995
This issue contains documents officially
filed through March 31, 1995.
n. IN ADDITION
NPDES Permit
Wildlife Resources Commission Proclamation
54- 55
56
57
Office of Administrative Hearings
Rules Division
424 North Blount Street (27601)
PO Drawer 27447
Raleigh, NC 27611-7447
(919) 733-2678
FAX (919) 733-3462
Julian Mann III, Director
James R. Scarcella St., Deputy Director
Molly Masich, Director of APA Services
Ruby Creech, Publications Coordinator
Teresa Kilpatrick, Editorial Assistant
Jean Shirley, Editorial Assistant
HI. PROPOSED RULES
Environment, Health, and Natural Resources
Sedimentation Control Commission 149 - 150
Human Resources
Medical Assistance 118- 122
Medical Care Commission 58-118
Mental Health, Developmental Disabilities and
Substance Abuse Services 118
Justice
Departmental Rules 122 - 142
Labor
Job Listing Services Act 149
Migrant Housing Act of NC 1 49
Retaliatory Employment Discrimination Act 149
Wage and Hour 142-149
Licensing Boards
Acupuncture Licensing Board 150- 151
Medical Examiners 151 - 157
Real Estate Commission 157 - 166
IV. LIST OF RULES CODIFIED 167-169
V. RRC OBJECTIONS 170
VI. CONTESTED CASE DECISIONS
Index to ALJ Decisions 171 - 175
Text of Selected Decisions
94 CPS 0237 176-178
94 EDC 0533 179-184
95 EHR 0140 185-186
VH. CUMULATIVE INDEX 188-190
♦
NORTH CAROLINA REGISTER
Publication Schedule
(November 1994 - September 1995)
Volume
and
Issue
Number
Issue
Date
Last Day
for
Filing
Last Day
for Elec-
tronic
Filing
Earliest
Date for
Public
Hearing
15 days
from
notice
* End of
Required
Comment
Period
30 days
from
notice
Last Day
to Submit
toRRC
** Earliest
Effective
Date
9:15
11/01/94
10/11/94
10/18/94
11/16/94
12/01/94
12/20/94
02/01/95
9:16
11/15/94
10/24/94
10/31/94
11/30/94
12/15/94
12/20/94
02/01/95
9:17
12/01/94
11/07/94
11/15/94
12/16/94
01/03/95
01/20/95
03/01/95
9:18
12/15/94
11/22/94
12/01/94
12/30/94
01/17/95
01/20/95
03/01/95
9:19
01/03/95
12/08/94
12/15/94
01/18/95
02/02/95
02/20/95
04/01/95
9:20
01/17/95
12/21/94
12/30/94
02/01/95
02/16/95
02/20/95
04/01/95
9:21
02/01/95
01/10/95
01/18/95
02/16/95
03/03/95
03/20/95
05/01/95
9:22
02/15/95
01/25/95
02/01/95
03/02/95
03/17/95
03/20/95
05/01/95
9:23
03/01/95
02/08/95
02/15/95
03/16/95
03/31/95
04/20/95
06/01/95
9:24
03/15/95
02/22/95
03/01/95
03/30/95
04/17/95
04/20/95
06/01/95
10:1
04/03/95
03/13/95
03/20/95
04/18/95
05/03/95
05/22/95
07/01/95
10:2
04/17/95
03/24/95
03/31/95
05/02/95
05/17/95
05/22/95
07/01/95
10:3
05/01/95
04/07/95
04/17/95
05/16/95
05/31/95
06/20/95
08/01/95
10:4
05/15/95
04/24/95
05/01/95
05/30/95
06/14/95
06/20/95
08/01/95
10:5
06/01/95
05/10/95
05/17/95
06/16/95
07/03/95
07/20/95
09/01/95
10:6
06/15/95
05/24/95
06/01/95
06/30/95
07/17/95
07/20/95
09/01/95
10:7
07/03/95
06/12/95
06/19/95
07/18/95
08/02/95
08/21/95
10/01/95
10:8
07/14/95
06/22/95
06/29/95
07/31/95
08/14/95
08/21/95
10/01/95
10:9
08/01/95
07/11/95
07/18/95
08/16/95
08/31/95
09/20/95
11/01/95
10:10
08/15/95
07/25/95
08/01/95
08/30/95
09/14/95
09/20/95
11/01/95
10:11
09/01/95
08/11/95
08/18/95
09/18/95
10/02/95
10/20/95
12/01/95
10:12
09/15/95
08/24/95
08/31/95
10/02/95
10/16/95
10/20/95
12/01/95
This table is published as a public service, and the computation of time periods are not to be deemed binding
or controlling. Time is computed according to 26 NCAC 2B . 0103 and the Rules of Civil Procedure, Rule 6.
* An agency must accept comments for at least 30 days after the proposed text is published or until the date
of any public hearing, whichever is longer. See G.S. 150B-2 1.2(f) for adoption procedures.
** The "Earliest Effective Date" is computed assuming that the agency follows the publication schedule above,
that the Rules Review Commission approves the rule at the next calendar month meeting after submission, and
that RRC delivers the rule to the Codifier of Rules five (5) business days before the 1st day of the next calendar
month.
Revised 10/94
EXECUTIVE ORDERS
EXECUTIVE ORDER NO. 73
SUSPENSION OF RULES
DURING LOCAL EMERGENCIES
WHEREAS, electric service is one of the most essential
services required by modern society, and the public welfare
is immediately threatened by any occurrences, natural or
manmade, which interrupt the delivery of electricity and
electrical services; and
WHEREAS, state and federal regulations prohibit electric
supplier vehicles and commercial motor vehicle drivers from
working extended hours to assist in the repair of damage
and restoration of the delivery of electricity and electrical
services; and
WHEREAS, federal law, specifically 49 C.F.R. Section
390.23, allows a Governor to suspend these rules and
regulations if the Governor determines that an emergency
condition exists.
NOW, THEREFORE, by the authority vested in me as
Governor by the laws and Constitution of the State of North
Carolina, IT IS ORDERED:
Section 1.
Electric supplier vehicles and commercial motor vehicle
drivers are exempt from the rules and regulations restricting
their participation in emergency relief efforts during a "local
emergency." A "local emergency" shall be considered to
be any power outage or interruption of electric service that
occurs within the State of North Carolina, including a near
term threat or occurrence of a meteorological condition or
other condition reasonably likely to result in power outages
or electric service interruption. A "local emergency" begins
when the affected electric supplier receives notice of the
power outage or interruption of electric service or receives
notice of the existence of conditions reasonably likely to
result in power outages or electric service interruption. The
"local emergency" continues until the necessary maintenance
or repair work is completed and personnel utilized to
perform necessary maintenance or repair work have returned
to their respective normal work routines.
This Executive Order is effective immediately.
Done in the City of Raleigh this the 15th day of March,
1995.
EXECUTIVE ORDER NO. 74
DESIGNATING THE YEAR OF THE
MOUNTAINS AND CREATING THE YEAR
OF THE MOUNTAINS COMMISSION
WHEREAS, North Carolina's mountains are among the
state's most valuable and unique assets; and
WHEREAS, North Carolina's mountains merit widespread
appreciation and understanding; and
WHEREAS, growth and change have brought new sets of
opportunities and challenges to people of the mountains; and
WHEREAS, regional efforts and partnerships with the
State are needed to address challenges facing mountain
communities today and in the future; and
WHEREAS, new initiatives for Western North Carolina
can honor and share the culture and history of the mountains
and enhance respect for the natural beauty and environment
of the region while fostering quality growth and develop-
ment; and
WHEREAS, the people of North Carolina's mountains are
pursuing a new vision for the mountains that integrates the
needs of young people, education, technology, industry, and
recreation while protecting the region's resources and
quality of life; and
WHEREAS, the people of North Carolina's mountains
seek to enhance Regional Identity and Recognition, to
cultivate Sustainable Communities, and to promote and
support Mountain Stewardship.
NOW, THEREFORE, by the power vested in me as
Governor by the Constitution and laws of North Carolina,
IT IS ORDERED:
Section 1. Year of the Mountains.
The Year of the Mountains is hereby designated July 1 ,
1995 through June 30, 1996.
Section 2^ Establishment.
The Year of the Mountains Commission is hereby estab-
lished.
Section 3. Membership and Terms.
The Governor shall appoint 15 persons to serve on the
Commission and shall designate one of its members to serve
as Chair. The Commission shall meet regularly to carry out
its duties at the call of the Chair.
Section 4. Powers and Duties of the Commission.
A. To develop a set of recommendations to effectuate
the purposes of this Order through such activities
as meetings, fact-finding tours, educational events,
and reports.
B. To focus statewide media and public attention on
the mountains to enhance quality growth and
development, protect the natural beauty, and
preserve the culture of the region.
C. To coordinate its efforts with local officials and to
help promote mountain events.
D. To perform and exercise such other duties and
10:2
NORTH CAROLINA REGISTER
April 17, 1995
54
EXECUTIVE ORDERS
powers as may be necessary to accomplish the
purposes of this Executive Order.
Section 5^. Administration.
The Governor shall designate an Executive Coordinator to
provide professional assistance and background information
to the Commission, and coordinate its activities. The
Executive Coordinator shall maintain the official minutes
and other records of the Commission, and shall work in
partnership with local and state governmental agencies, the
community college and university system, and the private
nonprofit sector to furnish additional staff assistance,
educational and research materials, and any other adminis-
trative support which the Commission may require.
The Executive Coordinator shall report directly to the
Commission and shall carry out its goals as set forth in the
Commission's mission statement. Members of the Commis-
sion shall receive necessary travel and subsistence expenses
pursuant to N.C.G.S. 138-5. Funding for the Executive
Coordinator and the Commission shall be provided by
DEHNR, the Department of Commerce, the Department of
Cultural Resources, and monies appropriated by the General
Assembly.
The Commission is authorized to accept donations of in-
kind services and funds, subject to the Executive Budget
Act. Western North Carolina Tomorrow (WNCT), a
501(c)(3) nonprofit, has agreed to administer the funds,
including those previously appropriated to it by the General
Assembly.
The Commission shall be considered a "public body" and
its meetings shall be open to the public pursuant to General
Statutes Chapter 143, Article 33C. The Commission, for
administrative purposes only, shall be located in the
Governor's Office.
This Executive Order shall be effective immediately and
expire June 30, 1996.
Done in the Capital City of Raleigh, North Carolina, this
the 27th day of March, 1995.
<
I
i
55
NORTH CAROLINA REGISTER
April 17, 1995
10:2
IN ADDITION
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
PUBLIC NOTICE OF INTENT TO ISSUE STATE GENERAL NPDES PERMITS
Public notice of intent to modify State National Pollutant Discharge Elimination System (NPDES) General Permits for Point
Source Discharges of Stormwater associated with the application requirements and clarifications of the visual monitoring
requirements in :
NPDES No. NCGO 10000 governing the discharge of stormwater associated with construction activities including clearing,
grading and excavation activities resulting in the disturbance land areas.
On the basis of preliminary staff review and application of Article 21 of Chapter 143 of the General Statutes of North
Carolina, Public Law 92-500 and other lawful standards and regulations, the North Carolina Environmental Management
Commission proposes to modify State NPDES General Permits for the discharges as described above.
INFORMATION: Copies of the draft NPDES General Permits and Fact Sheets concerning the draft Permits are available
by writing or calling:
Bill Mills
Water Quality Section
N.C. Division of Environmental Management
P.O. Box 29535
Raleigh, North Carolina 27626-0535
Telephone (919) 733-5083 ext. 548
Persons wishing to comment upon or object to the proposed determinations are invited to submit their comments in writing
to the above address no later than May 26. 1995 . All comments received prior to that date will be considered in the final
determination regarding permit issuance. A public meeting may be held where the Director of the Division of Environmental
Management finds a significant degree of public interest in any proposed permit issuance.
The draft Permits, Fact Sheets and other information are on file at the Division of Environmental Management, 512 N.
Salisbury Street, Room 925-C, Archdale Building, Raleigh, North Carolina. They may be inspected during normal office
hours. Copies of the information of file are available upon request and payment of the costs of reproduction. All such
comments and requests regarding these matters should make reference to the draft Permit Number, NCG010000.
Date: March 29, 1995
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
10:2 NORTH CAROLINA REGISTER April 17, 1995 56
IN ADDITION
North Carolina Wildlife Resources Commission
512 N. Salisbury Street, Raleigh, North Carolina 27604-1188, 919-733-3391
Charles R. Fullwood, Executive Director
PROCLAMATION
Charles R. Fullwood, Executive Director, North Carolina Wildlife Resources Commission, acting pursuant to North
Carolina General Statute §113-292 (cl) and authority duly delegated by the Wildlife Resources Commission, hereby declares
that the season for harvesting striped bass by hook-and-line shall close in all waters of the Roanoke River Striped Bass
Management Area downstream of the Edwards Ferry Boating Access Area at US 258 bridge on the Roanoke River in Halifax
County at 12:00 midnight on Sunday April 9, 1995.
In the Roanoke River and its tributaries upstream of the Edwards Ferry Boating Access Area at US 258 bridge
striped bass may be harvested from 12:01 a.m. on Saturdays through 12:00 midnight on Sundays, and from 12:01 a.m.
through 12:00 midnight on Wednesdays. On all other days all striped bass caught, regardless of condition, shall be
immediately returned to the waters where taken and no striped bass may be possessed.
The Roanoke River Striped Bass Management Area is defined as the inland and joint fishing waters of the Roanoke
River and its tributaries, extending from its mouth to Roanoke Rapids Dam, including the Cashie, Middle, and Eastmost
rivers and their tributaries.
This proclamation shall be effective at 12:00 midnight on April 9, 1995 and shall remain in effect until a new
proclamation closing described waters or portions thereof for striped bass fishing is issued.
This proclamation supercedes and replaces all prior proclamations.
NOTES:
a) This Proclamation is issued under the authority of N.C.G.S. §§113-132; 113-134; 113-292; 113-304; and
113-305.
b) All striped bass regardless of condition caught during the closed season shall be immediately returned to
the waters where taken and no striped bass may be possessed.
c) Any person who violates this Proclamation also violates applicable law and is subject to the sanctions
provided by law.
NORTH CAROLINA WILDLIFE RESOURCES COMMISSION
By: Charles R. Fullwood
Executive Director
Date: 4/3/95
57
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
TITLE 10 - DEPARTMENT OF
HUMAN RESOURCES
Notice is hereby given in accordance with G.S.
150B-21.2 that the NC Medical Care Commission
intends to repeal rules cited as 10 NCAC 3H .0108 - .0109,
.0206 -.0220, .0306- .0318, .0407 - .0409, .0505 - .0507,
.0510 - .0517, .0605 - .0609, .0705 - .0712, .0810 - .0812,
.0903 - .0911, .1003 - .1008, .1105 - .1109, .1130 - .1136,
.1150 -.1163, .1204- .1208, .1210, .1306- .1308, .1405
- .1406, .1408- .1410, .1501 - .1503, .1612 - .1613, .1703
- .1704, . 1804 - . 1807; and adopt rules cited as 10 NCAC
3H .2001, .2101 - .2110, .2201 - .2212, .2301 - .2308,
.2401 - .2402, .2501 - .2506, .2601 - .2607, .2701, .2801
- .2802, .2901 - .2902, .3001 - .3005, .3011 - .3016, .3021
- .3032, .3101 - .3104, .3201 - .3202, .3301 - .3302, .3401
- .3404.
Proposed Effective Date: September 1, 1995.
A Public Hearing will be conducted at 9:30 a. m. on June
9, 1995 at the Council Building, Room 201, 701 Barbour
Drive, Raleigh, NC.
Reason for Proposed Action: To update state regulations
for nursing homes to be compatible with federal regulations.
Comment Procedures: In order to allow the Commission
sufficient time to review and evaluate your written comments
prior to the hearing, please submit your comments to Mr.
Jackie Sheppard, APA Coordinator, DFS, P. O. Box 29530,
Raleigh, NC 27626-0530, telephone (919) 733-2342 by May
31, 1995, but in no case later than the hearing on June 9,
1995.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
CHAPTER 3 - DIVISION OF FACILITY
SERVICES
SUBCHAPTER 3H - RULES FOR THE
LICENSING OF NURSING HOMES
SECTION .0100 - GENERAL INFORMATION
.0108 DEFINITIONS
Th e following d e finitions will apply throughout this
Subohaptor:
~m "Abuse" moans the willful infliction of physical
pain, injury, mental anguish or unreasonable
confinem e nt whioh may oauoo or r e sult in t e mpo
rnry or p e rman e nt mental or physioal injury, pain,
harm, or death. — Abuse includes, but i s not limited
to, the following!
(ft) Verbal abuse — any us e of oral, written or gos
-&-
-(e)-
-(d)-
-(e)-
-O)-
-m-
-w-
-&-
-m-
■&-
-(*>-
-m-
turod language whioh a reasonable person would
view as disparaging and d e rogatory tormo to a
pati e nt rogardlooo of his or her ago, ability to
comprehend or disability;
Sexual abu s e — sexual harassment, s exual coor
oion or sexual assault of a pati e nt;
Physioal abus e — hitting, clapping, kicking or
corporal punishment of a patient;
Mental abuse language or treatment which
would b e vi e w e d by a reasonabl e person as
involving humiliation, harassm e nt, threats of
punishment or deprivation of a patient;
— Unreasonable confinement — the separation of a
patient from oth e r persons, or from hio or h e r
room, against th e pati e nt's will or th e will of the
patient's legal representative. Unreasonable
confinement does not include emergency — e*
short term monitor e d s e paration used as th e m
poutio intervention to r e duo e agitation until a
plan of care i s developed to moot the patient's
needs.
"Accident" moans an unplann e d or unwanted event
resulting in th e injury or wounding, no matt e r how
slight, of a patient or other individual.
"Adequate" — moans, — when applied — to various
s e rvioos, that the sorvioos ar e at least satisfactory
in mooting a r e f e rr e d to need wh e n moaaured
against contemporary professional standards of
practice.
"Administrator" m e ans the person who has author
ity for and is r e sponsibl e for the ov e rall op e ration
of a facility.
"Appropriate" moans right for the specified use or
purpose, suitabl e or prop e r wh e n used as an
adj e ctiv e . — When us e d as a transitiv e v e rb it moans
to sot aside for s ome specified exclusive u s e.
"Brain injury long term care" is defined a s an
interdisc i plinary, intensive maint e nanc e program
for pati e nts who hav e incurr e d brain damag e
caused by external physical trauma and who have
completed — a primary — course of rehabilitative
treatment and hav e r e aohod a point of no gain or
progr e ss for more than thr ee consecut i v e months.
Service s are provided through a medically supe r
vised interdisciplinary process and are directed
toward maintaining the individual at th e optimal
l e v e l of physioal, oognitiv e and behavioral funo
tion s .
"Capacity" moans the maximum number of patient
or resid e nt b e ds for whioh th e faoility is licensed
to maintain at any giv e n tim e . —
"Combination facility" moans a combination hom e
as defined in G.S. 13 IE 101.
Conval e scent care" — m e ans oaro givon for the
purpos e of assisting th e patient or r e sid e nt to
regain health or strength.
-(40) "Department" means the North Carolina Depart
10:2
NORTH CAROLINA REGISTER
April 17, 1995
58
PROPOSED RULES
-W
-tm-
4U>-
<m-
-m-
-m-
■w-
-(30)-
-(3+)-
-(33)-
-(33)-
mont of Human Resources.
"Dir e otor of Nursing" rooano th e nuroe who hao
authority and dir e ot r e oponoibility for all nursing
services and nursing oare.
"Drug" moana subotanooo;
-(a) recognized in tho offioiol United Statoo Pharm a-
oopo e ia, offioial National Formulary, or any
supplement to any of thorn;
(te) intended for uoo in tho diagnosis, euro, miti ga-
tion, treatm e nt, or pr e v e ntion of diseas e in man
or other animalo;
(e) intended to affect tho structure or any function
of tho body of man or other animals, i.e.,
subotanooo other than food; and
(d) intended for uoo as a oomponont of any artiol e
specified in (a), (b), or (c) of this Subparagraph.
(13) "Duly licensed" moans holding a current and valid
lioono e as requir e d und e r the G e n e ral Statutes of
North Carolina.
"Existing facility" — moans a facility currently
licensed or a proposed facility, proposed addition
to a lioonood — faoility or propos e d r e mod e l e d
lioonood facility that — will be built aooording to
plans and specifications which — have boon ap
proved by tho Department through tho prolimi
nary working drawings otato prior to th e e ff e otiv e
date of thio Rule.
(15) "Exit oonforonoo" moans tho conference hold at
tho end of a survey, or investigation between tho
D e partm e nt's — representativ e s — and th e faoility
administration r e presentativ e .
"Finding" moans a determination by tho Depart
meet that an allegation of patient abuse or neglect,
or misappropriation of pati e nt property has boon
substantiated.
"HIV Unit" moans designated areas dedicated to
pationts or residents known to have Human Imn w-
nod e fioionoy Virus dio e ao e .
"Incid e nt" m e ans an unplanned or unwanted e v e nt
which has not caused a wound or injury to any
individual but whioh has tho potential for such
should th e e v e nt bo repeated.
"Int e rdisciplinary" m e ans an int e grated process
involving a roprosontativo from each discipline of
tho health care team.
"Lio e nc e d praotioal nuro e " m e ans a nurs e who is
duly lic e nc e d ao a praotioal nurs e und e r G.S. 90,
Article 9A.
"Licensee" moan s tho person, firm, partner s hip,
aooooiation, corporation or organization to whom
a lic e nse hao boon ioouod.
"Medication" moans drug as defined in (11) of
thio Rule.
"Misappropriation of prop e rty" m e ans th e criminal
taking, uoo, exploitation of, dootruotion of, or
damage to, a patient' s bolonging s or money. — The
Department must prove tho misappropriation of
prop e rty by a pr e pond e ranc e of th e e vid e nc e .
Conviction of tho criminal act is not a prerequisite
to placing a finding conc e rning th e mioappropria
tion of prop e rty on th e North Carolina Nurs e Aid e
Registry.
(2 4 ) "Nogloot" moans a failure through a lack of
att e ntion, oarelooon e oo, or omission, to provid e
tim e ly and oonoiotont o e rvio e o, tr e atm e nt or oare to
a patient or patients whioh are nooooBary to obtain
or maintain tho patient's of pationts' health, safety
or oomfort.
"N e w faoility" moans a proposed faoility, a pro
po s ed addition to an existing facility or a proposed
remodeled portion of an existing faoility that i s
oonotruoted aooording to plans and specifications
approved by th e D e partm e nt subs e qu e nt to th e
effective date of this Rule. — If d e termined by tho
Department that more than half of an existing
faoility i s ro modeled, th e entire existing faoility
shall b e consid e r e d a n e w faoility.
"Nuroo Aide" moans any individual providing
-(35)-
-(36)-
nursing or nuroing related service s to patients
in a faoility who io not a lioonsed h e alth
prof e ssional, a qualifi e d di e titian, or someon e
who volunteers — to provide such services
without pay, and listed in a nurse aide regis
try approved by th e D e partm e nt.
"Nuro e Aid e Trainee" moans an individual
-&¥
who has not completed an approvod nurse
aide training course and competency ovalua
tion and is d e monstrating knowl e dg e , whil e
p e rforming tanks for whioh th e y have boon
found proficient by an instructor. — Those
tasks shall bo performed under tho direct
supervision of a r e gister e d nurs e . — Th e term
do e o not apply to volunteers.
(2 8 ) "Nursing Faoility" means that portion of a
nursing homo certified under Title XIX of tho
Social S e ourity Aot (M e dicaid) as in oompli
anoo with f e d e ral program standardo for
nuroing facilities. It io often used as s ynony
rnous with tho term "nursing home" which i s
th e usual pr e r e quisite lovol of state lioonsuro
for nursing faoility (NF) o e rtifioation and
Medicare — skilled — nursing — faoility — (SNF)
certification.
-(39) "Nurs e in oharg e " means th e nurs e to whom
duti e s for a sp e cified numb e r of pati e nts and staff
for a spec i fied period of time have boon delegated,
such as for Unit A on tho 7 3 or 3 11 shift.
"On duty" — moans personnel — who ar e awak e t
-(30)-
droooed, — responsive to patient needs and physi
colly present in tho facility performing assigned
duties.
"Op e rator" m e ans the owner of tho nursing hom e
busineoo.
"Patient" moans any person admitted for nursing
-(34)-
-(33)-
-(334-
"P e reon" m e ans an individual, trust, e state, part
59
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
norah i p of oorporation — including associations,
joint steefc compani e s and inouranoo oompanieo.
(34) "Propooal" m e ans a Negativ e Aotion Proposal
containing dooumontation of findings that may
ultimately bo classified ao violations and penalized
accordingly.
(35) "ProviBional Lio e noo" moans an amonded lioonoe
recognizing significantly looo than full oomplianoo
with the lioonsuro rules.
(36) "Phyoioian" m e ano a p e rson licens e d und e r G.S.
Chapter 90, Artiol e 1 to pmotio e m e dicine in North
Carolina.
(37) "Qualified Activit i es Director" moans a person
who hao the authority and r e sponsibility for th e
dir e otion of all thorapoutio aotivitioo in th e nursing
fac i lity and who meets the qualifications sot forth
under 10 NCAC 3H .120 4 .
(3 8 ) "Qualified Di e titian" m e ano a p e rson who meets
th e standards and qualification e otablioh e d by th e
Commission on Dietetic Registration of the Amor
icon Dietetic Association included in "Standard s of
Praotio e " — o e v e n dollars and tw e nty fiv e o e nts
($7.25) or "Cod e of Ethioo for th e Profession of
Dietetic s " two dollars and fifteen oenta ($2.15),
-m-
I
-(«)-
-m-
I
American Dietetic A s sociation, 216 W. Jackson
Blvd., Chioago, IL 60606 6995.
"Qualifiod Pharmac i st" means a p e rson who io
licensed to practice pharmacy in North Carolina
and who moots the qualifications sot forth under
10 NCAC 3H .0903.
-(40) "Qualifi e d Social Sorvioes Director" — means a
person who has the authority and responsibility for
the provision of social sorvioes in the nursing
hom e and who moots the qualification set forth
und e r 10 NCAC 3H .1306.
( 4 1) "Registered Nurse" moans a nurse who is duly
licensed as a registered nurse under G.S. 90,
Artiol e 9A.
"R e sid e nt" means any person admitt e d for oar e to
a domiciliary homo part of a combination homo
as defined in G.S. 131E 101.
"Sitt e r"m e ans an individual employed — te
provide companionship and sooial interaction
to a particular pationt, usually on a private
duty basis.
(44) "Supervisor in Charg e (domioiliary hom e )"
m e ans any e mploy ee to whom sup e rvisory
duties for the domiciliary homo portion of a
combination homo have boon delegated by
e ith e r th e Administrator or Dir e otor of Nurs
( 4 5) Surveyor" moons an authorized representative of
the Department who inspects nursing facilities and
combination faciliti e s to determin e oompliano e
with rulos ao s e t forth in G.S. 13 IE 117 and
applicable state and federal laws, rules and regula
l i on s .
( 4 6) "Ventilator dependence" is defined as phyoiologi
oal d e p e nd e ncy by a pati e nt on th e us e of a venti
lator for mor e than e ight hours a day.
( 4 7) "Violation" moans a finding which directly relates
to a patient' s health, safety or welfare or which
or e at e e a substantial risk that d e ath or s e rious
physical harm will occur and is d e t e rmin e d to b e
an infraction of the regulations, standard s and
requirements sot forth in G.S. 13 IE 117 or appl i
cabl e state and f e d e ral laws, rul e s and r e gulations.
Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a).
.0109 EXEMPTIONS AND WAIVERS
(a) Faciliti e s e x e mpt from rul e s for lio e nour e contained in
this Subchapter are:
(4-) facilities operated by the federal government;
(2) faciliti es lioonood as a part of a ho s pital subj e ot
to lio e nsur e under G.S. 13 IE, Artiol e 5, and
G.S. 122C, Article 2, and
(3) facilities operated by the State of North Caro
(b) Waiv e rs of rul e s in this Subchapter are not authoriz e d
by the Nursing Homo Lioonsuro Act.
Statutory Authority G.S. 13 IE- 104.
SECTION .0200 - LICENSURE
.0206 LICENSE REQUIRED
No p e rson defined in G.S. 13 IE 1(2) shall operate a
nursing homo except as provided for in G.S. 13 IE 102.
Those referenced statutes are adopted in accordance with
G.S. 150B 14(o).
Statutory Authority G.S. 131E-104; 150B- 14(c).
.0207 APPLICATION REQUIRED
(a) An application for lio e nour e shall bo submitted to the
Department prior to a license being issued.
(b) The Department shall bo notified in writing prior to
th e ooourr e no e of any of th e following oiroumstanoos:
(4-) final sit e o e l e otion, whioh must b e approv e d by
the Department prior to con s truction;
(3) construction of a now facility or any renovation
of an e xisting fac i l i ty;
(3) inor e ao e or d e cr e as e in b e d capacity for any
level of caro;
(4) the acquisition of a nursing homo or any change
in own e rship including any change in a partner
ship; or
(5) change of name or location.
Statutory Authority G.S. 13 IE- 104.
.0208 CONTENTS OF APPLICATION
The application shall contain the following;
10:2
NORTH CAROLINA REGISTER
April 17, 1995
60
PROPOSED RULES
-(-!-) name and address of applicant;
-(3) name and ourr e nt lioeno e number of tho Adminio
trator;
-(3) typo of facility to bo operated;
-(4) location of tho facility;
-(£) tho nam e and prinoipal buoinooo addr e oo of e aoh
partner, if applicant io a partnorohip t
-(6) tho namo and prinoipal business addrooo of oaoh
and all officers and diroctoro as well as tho name
and prinoipal bucin e oo addrooo of e aoh stockhold e r
owning (dirootly or indirootly) T e n p e ro e nt or
moro of tho stock; and
-f?) such other documents or information as necessary
to det e rmine complianc e with applicabl e rul e o and
statutes as w e ll as tho magnitud e and oeope of
services to bo offered.
Statutory Authority G.S. 131E-104.
.0209 ISSUANCE OF LICENSE
Only one liconso shall bo issued to each facility. — The
Departm e nt shall ioc . ua a lioonoo to tho operator of th e
nursing hom e buoinooo upon v e rification of complianc e with
applicable laws and rules.
Statutory Authority G.S. 13 IE- 104.
.0210 EXPIRATION
Each license shall expire at midnight on tho expiration date
of th e lio e ns e e xo e pt ao oth e rwioo provided in G.S. 150B 3.
Statutory Authority G.S. 131E-104.
.0211 RENEWAL
Eaoh licens ee shall fil e an application for renewal of
liconso with tho Department at least 30 day s prior to tho
date of expiration on forms furnished by tho Department.
Failure to fil e a r e n e wal application shall result in e xpiration
of th e lio e ns e to op e rat e .
Statutory Authority G.S. 13 IE- 104.
.0212 TYPES OF LICENSE
A liconso shall bo issued for a 12 month period; however,
a provisional liconso may bo issued for a period of loss than
12 months in eas e s wh e re th e facility has not fully compli e d
with G.S. Chapter — 13 IE, Artiol e 6, Part A and rules
contained in this Subchapter, and such noncompliance does
not pose an immediate hazard to tho life or safety of tho
persons oorvod.
Statutory Authority G.S. 131E-104.
.0213 POSTING OF LICENSE
Th e lioenoo shall b e post e d in a promin e nt looation,
accessible to public view, within tho licensed promises.
Statutory Authority G.S. 13 IE- 104.
.0214 EXCEEDING LICENSED CAPACITY
(a) A lif e oare o e nter having an agroomonto to oar e for all
residents regardless of level of care need s may temporarily
increase bod capac i ty by ten percent or ton bods, whichever
io loco, ov e r th e lic e ns e d b e d oapaoity for a p e riod up to 30
days following notification of and approval by tho Depart
mont, provided such increase is not aoeooiatod with a capital
expenditure.
— (b) A facility oth e r than a lif e oar e o e nt e r shall aooopt no
mor e pati e nts than th e numb e r for which it io lio e nood in
each level of care oxoopt in an emergency situation ap
proved in advance and confirmed in writing by tho Deport
m e nt. — Em e rg e ncy authorizations shall not oxoood seven
calendar days and shall not oxoood th o total lio e no e d b e d
capacity for tho facility.
Statutory Authority G.S. 131E-104.
.0215 TRANSFERABILITY
licenses aro not transferable. — A licensee shall notify tho
D e partm e nt in writing of any propoood chang e in own e rship
at loast 30 days prior to th e e ff e ctiv e date of th e chang e .
Tho now owner shall be responsible for submitting an
application for license at loast 30 days prior to assuming
own e rship.
Statutory Authority G.S. 131E-104.
.0216 DENIAL, AMENDMENT, OR REVOCATION
OF LICENSE
(a) Tho Department shall deny any licensure application
upon becoming awaro that tho applicant is not in compliance
with any applicabl e provision of the Certificate of Nood law
locat e d in Artiol e 9 of Chapter 13 IE of th e G e n e ral Statutes
and tho rule s adopted under that law.
(b) Tho Department may amend a liconso by reducing it
from a full lio e ns e to a provisional lio e ns e wh e n e v e r th e
D e partment finds that:
(4-) tho licensee has substantially failed to comply
with tho provisions of Part A of Article 6 of
Chapt e r 13 IE of th e G e n e ral Statut e s and th e
rules promulgated under that Part; and
(3) there is a reasonable probability that tho licensee
can remedy tho licensure deficiencies withi a-ft
reaoonabl e l e ngth of tim e ; and
(3-) th e r e is a reasonable probability that tho lioonooo
will bo able thereafter to remain in complia flee
with tho nursing homo licensure rules for tho
forooooablo future.
The Departm e nt shall giv e th e license e written notic e of th e
amondmont of his license. — This notice shall be given by
registered or certified mail or by personal se r vice and shall
oot forth th e r e asons for th e action.
— (o) Th e provisional lic e nc e shall b e e ff e ctiv e imm e diat ely-
upon its receipt by tho licensee and must be posted in a
prominent looation, accessible to public view, within tho
lic e ns e d premis e s in li e u of th e full lic e ns e . Th e provisional
I
61
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
license shall remain in offoct until;
(i) th e D e partment rootoroo
the lioonooo — to full
lioonaur e otatuo; or
(3) the Deportment revokes the liconfloo'a license; or
(3) the end of the licensee's licensure year.
If a lioonooo has a provisional lio e no e at the tim e that th e
lioonooo oubmito a r e n e wal applioation, — the lio e no e , — if
fonowod, shall also bo a provisional license unless the
Department determine s that the licen s ee can bo returned to
full lio e nour e otatuo. — A dooioion to iooue a provisional
lioonoo is stay e d during the p e nd e noy of an administrativ e
appeal and the licensee may continue to display ito full
license during the appeal.
— (d) The D e partment may r e vok e a lio e no e whenever:
(4-) Th e D e partment findo that:
(A) — the lioonooo has substantially failed to comply
with the provisions of Parts A and B of Article
6 of Chapt e r 13 IE of th e G e n e ral Statutes and
the ruloo promulgated und e r thoo e parte; and
(B) — it i s not reasonably probable that the licensee
eon remedy the licensure deficiencies within a
reas onable l e ngth of tim e ; or
(3) Th e D e partment findo that:
(A) — the licensee has substantially failed to comply
with the provisions of Parts A and B of Article
6 of Chapt e r 13 IE of the General Statu t e e; and
(B) — although th e l i o o nooo may b e abl e to romody
the deficiencies within a reasonable time, it is
not reasonably probable that the licensee will
be abl e to remain in oompliano e with nursing
hom e lioenour e rul e s for th e fores ee abl e futur e ;
er
-(3) The Department finds that there has boon any
(c) — The suspension will bo effectiv e when the notice i s
s e rv e d or on th e date sp e cifi e d in th e notio e of ouop e noion,
whichev e r io later. Th e s usp e nsion will r e main effective for
the period specif i ed in the notice or until the facility
demonstrates to the Department that conditions are no longer
d e trim e ntal to th e h e alth and safety of th e patient.
(d) Th e nursing hom e ohall not admit n e w patients during
the effective period of the suspension.
Statutory Authority G.S. 131E-104.
.0218 PROCEDURE FOR APPEAL
— A nursing homo may appeal any decision of the Depart
m e nt to d e ny, revoke or alter a lioeno e or any decision to
susp e nd admiooions by making ouoh an appeal in aooordane e
with G.S. Chapter 150B and 10 NCAC IB .0200.
Statutory Authority G.S. 13 IE- 104.
.0219 INSPECTIONS
(a) Any nursing homo licensed by the Department may bo
insp e ct e d by any authoriz e d representative of the Depart
m e nt at any time. Generally, inspections will b e conduct e d
between the hours of 8 :00 a.m. and 6:00 p.m., Monday
through Friday. However, complaint investigations shall be
conducted at th e most appropriat e tim e for inv es tigating
all e gations of th e oomplam fcr
(b) At the time of inspection, any authorized roprooonta
tivo of the Department shall make his presence known to the
Administrator or oth e r p e rson in oharg e who ohall ooop e rate
with th e roprooontativ e (s) and faoilitat e th e inspection.
(c) Inspections of medical records will be carried out in
accordance with G.S. 13 IE 105.
failur e to oomply with th e provision s of Parts A (d) — Th e faoility Administrator shall provid e and mok e
and B of Articl e 6 of Chapter — 13 IE of th e
General Statutes and the rule s promulgated under
those parts that endangers the health, safety or
w e lfar e of th e pati e nts in th e facility.
availabl e to repres e ntativ e s of th e D e partm e nt finanoial and
statistical record s required to verify compliance with all
rules contained in this Subchapter.
— (e) — Th e D e partm e nt ohall mail a writt e n r e port of th e
Th e issuanc e of a provisional lio e no e is not a proc e dural lio e nour e surv e y or complaint investigation whioh shall
prerequisite to the revocation of a license pursuant to
Subparagraphs (d)(1), (2) and (3) of this Rule.
Statutory Authority G.S. 131E-104.
.0217 SUSPENSION OF ADMISSIONS
(a) — The Departm e nt may susp e nd th e admission of any
new patient to any nursing hom e wh e n warranted under the
provisions of G.S. 131E 109(c).
(b) — The Department shall notify' the nursing home by
o e rtifiod mail of th e d e cision to susp e nd admissions. — Suoh Statutory Authority G.S. 13 IE- 104.
notioe will includ e :
-(£) the period of the suspension;
include statements of any deficiencies cited to the facility
within 10 working days from the date of the licensu r e
survey or oomplaint inv e stigation e xit conf e r e nc e .
(f) The faoility Administrator ohall pr e par e a writt e n plan
of correction and mail it to the Department within 10
working days following receipt of any statement of dofioion
oioo. Th e plan of correction ohall b e r e vi e w e d and acc e pt e d
or r e j e ct e d with writt e n notio e giv e n to th e Administrator
within 10 working days of receipt by the Department.
-(3) factual allegations;
.0220
PUBLIC ACCESS TO DEPARTMENT
LICENSURE RECORDS
-(3) citation of statutes and rules alleged to b e vio
lat e d; and
-(4) notice of the facility's right to contested case
hearing on the s uspension.
(a) Exo e pt for documents containing th e information list e d
in Paragraph (b) of this Rul e , Departm e nt fil e s pertaining to
the licensure of any facility under this Subchapter shall bo
open to inspection by any member of the public during
10:2
NORTH CAROLINA REGISTER
April 17, 1995
62
PROPOSED RULES
normal bu s iness hours, aftor the Department has had a
roaoonablo opportunity to ensur e that none of th e informa
tion id e ntifiod in Paragraph (b) will bo disclos e d during th e
inspection. — Except for information identifiod in Paragraph
(b), any member of the publio may obtain copies of any
information oontain e d in the Departm e nt licensur e filoo,
subject to th e following conditions:
(1) Appropriate foots for the copying may bo charged
in advance; and
(3) Delivery of the oopioo may b e delay e d for a
roaoonabl e time if th e D e partm e nt otaff io e n
gaged in other duties at the time of the request,
(b) Unless disclosure is ordorod by a court of competent
jurisdiction, th e following olooo e o of information shall not b e
disoloo e d to members of th e publio:
(4) infonnati ea — about — the — diagnosis, — prognosis,
treatment, — or any other confidential medical
information undor G.S. 8 53, r e garding a nam e d
person, unl e ss that p e rson cons e nts in writing to
the disclosure;
(3) the name of any per s on who provided inform a-
tion concerning a faoility lio e nsod und e r this
Subohaptor, or r e gister e d a oomplaint about th e
treatment of a patient or resident, unless that
person consents to th e di s clo s ure;
(3) information identifying any p e rson as a r e cipi e nt
of publio asoistanoo or social s e rvioos, unl e ss
that person consents to the disclosure; and
(4) any confidential communioation between the
attorn e y for th e D e partm e nt and th e D e partm e nt.
(o) Wh e n docum e nts in th e fil e contain only confid e ntial
information of the typos identified in Paragraph (b), then
they will bo removed from the file before inspection. — tf-a
dooum e nt contains both information of thos e typ e s identifiod
in Paragraph (b) and non confid e ntial information, th e n the
Department will provide for inspection a copy of the
document — from which the confidential — informati on — is
dolotod, in li e u of th e original dooument. No ohargo will bo
made for this copying if the person insp e cting the fil e s does
not wish to retain the copies made.
Statutory Authority G.S. 8-53; 108A-80; 13 IE- 104;
131E-124(c); 132-1.1.
writton agroomont or in a facility's governing bylaw sr
—(e) The Administrator shall b e r e sponsible for the
op e ration of a faoility and all s e rvioes offered and for
compliance with all applicable state and federal laws and
regulations.
Statutory Authority G.S. 90-284; 131E-104.
.0307 VACANCY IN ADMINISTRATOR
POSITION
(a) If th e position of Administrator booomoo vacant, the
Department shall bo notified by the owner, licensee, or
Chairman of the Board of the nursing homo on the first
working day following suoh vaoanoy. — Th e notio e of a
vaoanoy shall oontain th e name and lio e ns e number of the
replacement or tho name of the person responsible for
operation of the facility during the absonoo of a lioensod
Administrator.
—(b) — A vaoanoy in th e Administrator's position shall bo
reviewed by tho Department every 30 days for licensure
action.
Statutory Authority G.S. 131E-104.
.0308 NUMBER OF FACILITIES SERVED
If an Administrator servos two or more faciliti e s locat e d
51 or more miles apart or having a combin e d b e d oapaoity
of moro than 130 bods, each faoility must have on Assistant
Administrator who is duly lioensod and has writton authority
to aot in th e Administrator's absenc e . Th e Assistant
Administrator shall not servo as th e Dir e otor of Nursing.
Statutory Authority G.S. 131E-104.
.0309 FISCAL MANAGEMENT
Tho Administrator of a facility shall establish and maintain
records relative to operating costs and statistical records of
th e op e ration of th e faoility whioh provid e a viable audit
trail. — Those rooords shall includ e , but not b e limited to,
detailed information indicating tho tim e worked by and
salary paid to all employees, food invoices, and daily census
information, including admissions and d i scharg e e. AH
r e oords shall b e maintain e d for at l e ast two y e ars.
SECTION .0300 - GENERAL STANDARDS OF
ADMINISTRATION
.0306 LICENSED ADMINISTRATOR
— (a) — Each facility shall bo under tho direct management
oontrol of one poroon who io ourrently lic e ns e d by th e North
Carolina Stat e Board of Examin e rs for Nursing Hom e
Administrators in accordance with G.S. 90, Article 20. — An
Administrator so licensed shall not bo subject to domiciliary
hom e or other faoility Administrator lioonsure r e quirem e nts
e stablished by any othor agonoy. — Th e Administrator shall
not sorvo simultaneously as tho Director of Nursing.
(b) If an Administrator is not tho solo owner of a facility,
hio authority and responsibility shall be oloarly d e fin e d in a
Statutory Authority G.S. 131E-104.
.0310 STATISTICAL DATA FOR STATE USE
The Admini s trator of a facility shall maintain and make
available to tho Department such statistical data as required
by statute or rul e s oontain e d in this Subohaptor, for tho
state's medical faciliti e s plan and/or proper review for
certificate of nood determination.
Statutory Authority G.S. 13 IE- 104.
.0311 ADMISSIONS
(a) No patient shall bo admitted except under tho orders
of a duly lioensod physioian.
63
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
(b) Tho Administrator ohall assure ? tuberculosis and other
oommunioabl e diooaoo oor ee ning on admiooion and tuborou
The facility Adminiotrator shall assure written policies and
procedures whioh aro availabl e to and impl e m e nted by staff.
looio ooreening annually thereafter until final dioohargo. Those polioi e o and proo e dur e o ohall oov e r at l e ast the
Identification of a communicable disease does not, in all
cases, in and of itself, preclude admission to the facility.
The faoility ohall provide appropriate oar e and tr e atm e nt.
—(e) — Tho faoility ohall aoquir e prior to or at th e time of
admission ordors from the attending physician for the
immediate care of tho patient or resident.
—(d) — Within 4 8 houro of admission, th e faoility shall
aoquir e modioal information whioh shall includ e ourr e nt
medical — findings, — diagnosis, — rehabilitation — potential, — a
summary of tho hospital stay if the patient is being trans
f e rr e d from a hospital, and ord e ro for th e ongoing oar e of
th e pati e nt.
(o) If a patient is admitted from s omewhere other than a
hospital, a phy s ical examination shall be performed either
within 5 days prior to admiooion or within 48 houro follow
ing admiooion.
—(f) — Now facilitie s must prepare a plan of admission
which, at a minimum, assures available staff time and plans
for individual patient aooooomont, initiation of health oare or
nuroing oar e piano, and impl e m e ntat i on of physioian and
nursing treatment plans. — This plan must bo available for
inspection during tho initial licen s ure s urvey prior to
ioouanoo of a lio e no e .
— (g) — Only p e rsons who are 1 8 years of age or old e r ohall
bo admitted to tho domiciliary home portion of a combine
tion faoility.
Statutory Authority G.S. 13 IE- 104.
.0312 PATIENTS AND RESIDENTS NOT TO BE
ADMITTED
Pationto or residents who r e quir e h e alth, habilitativ e , or
rehabilitative care o r training beyond those for whioh tho
facility is licensed and i s capable of providing s hall not bo
admitt e d.
Statutory Authority G.S. 131E-104.
.0313 DISCHARGE OF PATENTS
A record shall b e maintain e d of all d i scharges of patients
following areas:
— (4) admissions;
— (2) di e tary;
— (3) dischargee with physioian ord e rs and/or pati e nts or
residents leaving against physician advice;
— (4) gratuities and solicitation whioh at a minimum
shall — provid e that no own e r, op e rator, ag e nt or
e mploy ee of a — faoility nor any m e mb e r of his
family shall accept a gratuity directly or indirectly
from any patient or resident in tho facility or
s olioit for any typ e of contribution;
houookooping;
infection control which mu s t include, but is not
limited — to, requirements for sterile and aseptic
toohniquoo; universal and isolation pr e cautions and
oommunioable diooaoo ooreening i noluding annual
tuberculosis screening for all s taff and inpatients
of tho facility;
-(7) maintenance of pati e nt m e dioal or h e alth oar e
r e words inoluding charting or r e oord k ee ping;
orientation of all facility personnel;
patient or resident care plana, treatment and other
h e alth oar e or nursing oar e , inoluding but not
limited to all polioieo and prooedur e o r e quired by
rules contained in this Subchapter;
pationto' or re s idents' rights;
■im-
(11) physical evaluation for r e sid e nts and pati e nts at
l e ast annually;
(12) physician services and utilization of tho individ
uol'fl private physician;
(13) procur e m e nt of suppl ie s and e quipmont to moot
individual pati e nt oare uoodo;
(1 4 ) protection of pationto from abuse and neglect;
range of services provided;
-(45)-
(16) r e cording and reporting to tho Department of
accidents or incidents ooourring to pationto in any
part of tho facility and maintenance of such ro
ports or records;
(17) rehabilitat i on s e rvic es ;
(1 8 ) r e l e as e of m e dioal reoord informati efit
indicating tho reasons for discharge, the physician's order (19) screening and reporting oommunioable disease to
for or other authorization for discharge, and tho condition
of th e pati e nt at th e time of discharg e .
A patient known to hav e Human Immunod e fic ie ncy Virus (20)
disease may not bo discharged solely on tho basi s of tho
diagnosis of Human Immunodeficiency Virus disease except
ao authoriz e d by th e provisiono of N.C. G e n e ral Statut e
131E 117 (15) or other provioiono of th e N.C. G e n e ral
Statutes or regulations promulgated thereunder or provisions
of applicable federal law s and regulations.
Statutory Authority G.S. 13 IE- 104.
.0314 POLICES AND PROCEDURES
tho Department (Divi s ion of Health Service s ) and
local h e alth D e partm e nt;
transf e rs.
Statutory Authority G.S. 13 IE- 104.
.0315 NURSING HOME PATIENT RIGHTS
(a) — Written policies and procedures s hall bo developed
and enforced to implement requirements in G.S. 13 IE 115
et ooq. (Nuroing Hom e Pati e nts' Bill of Righto) concerning
th e righto of pati e nts. — Th e Adminiotrator ohall mak e th e s e
policie s and procedure s known to staff, patients and families
of patients and shall ensure their - availability to tho public by
10:2
NORTH CAROLINA REGISTER
April 17, 1995
64
PROPOSED RULES
placing thorn in a conspicuous plaoo,
(b) In matt e rs of patient abuo e , n e gleot or misappropria ^
tion the definitions oball hav e th e moaning d e fin e d in Rul e
.010 8 of this Subchapter.
Authority G.S. 131E-104; 131E-111; 131E-124; 131E-129;
42 U.S.C. 1396 r (e)(2)(B).
.0316 SAFETY AND ENVIRONMENTAL
CONTROL
(a) A lio e ns e d facility shall hav e polioi e s and proo e dur e s
for pationt safety and for environmental control which at a
minimum shall include infection control.
(b) A facility with a lic e ns e d oapaoity of 51 b e ds or mor e
shall have a safety and e nvironm e ntal control committee
which includes repre s entation from administration; medical
and nursing staff; pharmacy; maintenance, engineering or
housekeeping; and di e tary Borviooo,
(o) A faoility with a lio e ns e d oapaoity of 50 b e ds or l e ss
shall have a safety and environmental control committee
which at a minimum includes the Administrator and Diroc
tor of Nursing,
(d) All oommitte e m e mb e rs shall b e designated in writing.
(o) Responsibilities and duties of any safety and environ
mental committee shall include, but not bo limited to, the
following:
(4-) moot at least quarterly, maintain minutes inouffi
ciorjt detail to document committee proceedings
and actions, and submit reports to the Adminis
trator;
(3} e stablish an inoident — and aooidont — r e porting
system in accordance with facility policies which
includos a mechanism for reviewing, invoatigat
ing and e valuating all incid e nts and accid e nts
r e port e d. — The oommitt ee shall dooum e nt all
reviews and action(s) taken;
(£) conduct hazard surveillance program ;-
(4} oonduot fir e proteotion program whioh inolud e s:
(A) — developm e nt and adoption of a comprehensive
fire and disaster plan;
(£) — instruction and fire drills for all employees in
th e following:
(+) use of all alarms and signals;
(») methods of fire containment;
fiw) location and use of — fire fighting equip
mont;
(iv4 wh e r e , when and how to shut off oxyg e n
and air conditioni ng*-
fv) evacuation routes and procedures; and
(vi} transmission of an alarm to th e fir e D e
partro e nt or oth e r r e sponsibl e e m e rg e noy
services;
— assignment of specific responsibilities and tasks
to all personn e l in respons e to an alarm; and a
fir e drill for e aoh shift of omployooo at least
quarterly;
conduct water temperature surveillance program
whioh assures oompliano e with Rul e .1 8 07(d) of
this Subchapter;
-(6) annually r e vi e w polioieo and proo e dur e c for
inf e ction and communicable diooaoo oontrol;
(A) handling food;
-(€>
-(B) — processing laundry;
-(G)-
-0*-
disposing of e nvironmental or other waatoo and
pationt or r e oident ourgioal or wound dreoo
ings, porsonal care pads or other wastes;
(-B) — controlling poets and reporting infectiono and
dis e as e s;
f£) monitor ov e rall e nvironm e ntal/inf e otion oontrol
and implementation of safety policies and prooo
(&) monitor — staff d e v e lopment — te — assure — active
ongoing insorvio e — training at l e ast annually
which shall include universal precautions and
other areas of safety and environmental/infection
oontrol for all personnel; and
(9) aoting on r e quir e m e nts from th e Occupational
Safety and Health Administratio &r
Statutory Authority G.S. 13 IE- 104.
.0317 REPORTING AND INVESTIGATING ABUSE,
NEGLECT OR MISAPPROPRIATION
(a) Th e faoility shall tak e r e asonabl e m e aour e c to pr e v e nt
pati e nt abus e , pati e nt n e gl e ot, or misappropriation of pati e nt
property, including but not limited to orientation and
instruction of facility staff on patients' righto, and the
r e questing of referenoeo for all prospootivo employees.
(b) Th e Administrator shall aocuro that the Department is
notified of all alleged incidents which appear to a reasonable
person to bo related to pationt abuse, neglect or misappro -
priation of pati e nt prop e rty. —
(o) — Th e inoid e nt r e port s hall b e print e d or typ e d and
postmarked within 48 hours of the alleged inoident. The
report shall be conducted as specified in 42 CFR subsection
4 8 3.13 and shall consist of a simpl e statement of the
pati e nt's full nam e ; room numb e r; typ e of injury, date and
time of the alleged incident of abuse, neglect or misappro
priation of property; names of persons involved; and
imm e diat e aotion tak e n by th e faoility.
(d) Th e faoility shall thoroughly inv e stigat e and dooum e nt
according to 4 2 CFR subsection 48 3.13, whioh is incorpo
rated by reference, including subsequent amendments, all
all e g e d incid e nts whioh app e ar to a r e asonable person to be
inoid e nts of pationt abuo e , pati e nt negl e ot, or misappropria
tion of pationt property and 3hall take whatever steps are
necessary to prevent further incidents of abuse, neglect or
misappropriation of prop e rty whil e th e inv e stigation io in
progress.
Authority G.S. 131E-104; 131E-111; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396; 42 C.F.R. 483.
.0318 PERSONNEL STANDARDS
(a) The Administrator shall provide for the following;
(4-) numbers and typ e o of qualified personnel and
65
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
ancil l ary — services as necessary — to assure the
health, oafoty and proper oare of pationto and
rooid e nto;
(3) on duty personnel who for health or other rea
sons present no throat to the health and safety of
pationto and rooidento; and
(3) an individual p e rsonn e l rooord for e aoh e m
ployoo rogardlooo of job assignm ent Such
rooord shall bo kept current and shall include
oortifioate and lic e nsure numb e rs, when applioa
bio; the original application with v e rification of
credentials; periodic performance ovaluationo;
and a signed and dated certification that the
employee hao road and understood th e facility' s
polioioo governing conditiono of e mploym e nt,
including but not limited to on duty dross,
personal hygiene, sleeping on duty, ingestion of
alcohol or oth e r drugs, oonduot towards pati e nts
and rooidento, and th e w e aring of id e ntification
(b) Each employee shall bo assigned duties consistent with
hio job description and with hio level of e ducation and
training, which includes docum e nted on the job training and
experience and in service education.
Statutory Authority G.S. 131E-104.
SECTION .0400 - PATIENT OR RESIDENT CARE
ASSESSMENT AND PLANNING
.0407 GENERAL
The Admini s trator shall assure that policies and procedures
are available and implemented for assess i ng each patient's
or r e sid e nt's h e alth oar e noedo and planning for meeting
identifi e d health oare needs. Ther e shall b e a oyot e m for
evaluating the effectiveness of the assessment, planning and
implementation (delivery of care processes) for each patient
or resid e nt.
Statutory Authority G.S. 131E-104.
.0408 FREQUENCY, METHOD AND CONTENT
OF ASSESSMENT AND PLANNING
Each patient's and re s ident's condition must bo assessed
on a regular, periodic basis, at least quarterly, with appro
priato notation and updating of th e h e alth oar e plan. — Heakb
oare planning for eaoh pati e nt and resident shall bo an
on going proce ss and must include but may not bo limited
to the following!
(1) data whioh is syst e matically and continuously
ooll e ot e d about h e alth status; — Th e data shall b e
recorded so as to be accessible and communicated
to all s taff involved in the patient's o r resident
8
-m-
ourront probl e ms and n ee ds id e ntifi e d and priori
tizod from a completed assessment relevant to the
patient' s or resident's response to aging, illnes s
and his/her general health status; and
— (3) a ourr e nt plan of oar e d e v e lop e d in conjunction
with th e pati e nt or r e sid e nt and/or l e gal guardian
that includes measurable time related goals and
approaches, — or measures — to bo employed -by
various disciplines in order to aohi e v e th e idonti
fi e d goals.
Statutory Authority G.S. 131E-104.
.0409 IMPLEMENTATION OF HEALTH CARE
PLAN
All parts of the plan of care s hall be assigned to specific
disciplines or staff ao indicat e d in th e plan of oar e to assur e
that health oar e and r e habilitativ e services ar e p e rform e d
daily and documented for those patients and residents who
required s uch services.
Statutory Authority G.S. 13 IE- 104.
SECTION .0500 - NURSING SERVICES
.0505 NURSING/HEALTH CARE
ADMINISTRATION AND SUPERVISION
—(a) — A licensed facility shall have a Director of Nursing
s e rvic e who shall b e r e sponsibl e for th e overall organization -
and manag e m e nt of all nursing sorviooo and shall bo
currently licensed to practice as a regi s tered nurse by the
North Carolina Board of Nu rs ing in accordance with G.S.
9 0, Artiol e 9A.
(b) Th e Dir e ctor of Nursing shall not s e rv e ao Adminio
trator or Assistant Administrator.
(c) A licensed facility, with nursing facilitie s or combina
tion facilities shall provide a full time Director of Nursing
on duty at l e ast e ight hours p e r day, fiv e dayo a w ee k. — A
r egi s tered nurse s hall relievo the Director of Nursing (be in
charge of nursing) during the Director's absence.
(d) A l i c e ns e d facility shall e mploy and aooign registered
nurs e , licensed praotioal nurooo and nurse aid e o for duti e o in
accordance with G.S. 90, Article 9 A.
— (o) The Director of Nursing shall cau s e the following to
b e aooomplioh e d:
(4-) e stablishment and implementation of nursing
policies and procedures which shall include but
not bo limited to the following;
(A) — assessment of th e planning for patiento' nuro
ing oar e or h e alth oare needs, and impl e m e nta
tion of nursing/health care plans;
(B) — daily charting of any unu s ual occurrence s of
aout e e p i sod e s r e lat e d to pati e nt oar e , and
progress not e s written monthly r e porting e aoh
patient's — p e rforma nce — in — accordan ce — wkh
identified goal s and objective s and each pa
ti e nt's progress toward rehabilitative nursing
goals;
(€) — assurance of the delivery of nursing services in
accordance with phy s icians' order s , nur s ing
10:2
NORTH CAROLINA REGISTER
April 17, 1995
66
PROPOSED RULES
oaro plans and the facility's poliotoo and prooo
dur e s;
-(D) — notification of omerg e noy phyoioiano or on oall
physician s !
-(E) — infection control to provont cross infection
among pationto and staff shall b e in oonfor
monoo with 2 9 CFR 1910 (Oooupatioool Saf e ty
and Health Standards) which i s incorporated by
reference including subsequent amendments.
Emphaoio ohall b e plac e d on oomplianoe with
29 CFR 1910 1030 (Bloodbourn e Pathog e ns).
Copies of Title 29 Part 1910 may bo purchased
from the Superintendent of Documento, U.S.
Gov e rnm eat — Printing — Offio e , — Washington,
D.C. 20102 for $3 8 .00 or may bo purchased
with a credit card by telephone to the Govern
mont Printing Office at (202) 7 8 3 323 8 .
Inf e ction oontrol shall also b e in oompliano e
with the Center of Dio e ao e Control Guidelin e s
as published by the U.S. Department of Health
and Human Services, Public Health Service
whioh is incorporated by referenc e including
subsequent am e ndm e nts. Copi e s may b e
purohaoed from the National Tochnioal Infof
motion Service, U.S. Department of Com
m e ro e , 52 8 5 Port Royal Road, Springfi e ld,
Virginia, 22161 for $15.95.
-(F) — reporting of death s ;
-(G) — oroorgoncy reporting of fire, patient or staff
accid e nts or inoid e nto, or oth e r omergenoy
situations;
-(H) — use of protective device s or restraints to assure
that each pati e nt or resident is restrained 4b
accordance — with phyoioian — orders and the
faoility' s polioi e s, — and that th e r e strain e d
patient or resident i s appropriately evaluated
and released at a minimum of every 2 hours 1 ,
—(f) — sp e cial skin oar e and d e oubiti cor e ;
— (F) — bow e l and bladder training;
-(K) — maintenance of proper body alignment an d
restorative nur s ing care;
-(t) — supervision — of and assisting pationto with
-W-
-m-
feeding;
intake and output observation and reporting for
thooe patients whoso condition warrants moni
toring of their fluid balano e . — This will include
thooe pati e nts on intrav e nouo fluids or tub e
feedings, and patients with kidney failure and
temperatures elevated to 102 degree s F. or
abov e ;
oath e t e r oar e ; and
-m-
-m-
-(0) — procedures used in caring for patients in the
facility,
d e velopment of written job description s for
nursing p e roonnol;
periodic assessment of the nursing department
with identification of personnel requirements as
they relate to pati e nt oare needs and r e porting
-£)-
-&-
-<&-
same to the Administrate s
a plann e d ori e ntation and continuing inoorvioe
e ducation program for nursing e mployeoo and
documentation of staff attendance and subject
matter cove r ed during inooryioo education pro
gramo;
obtaining and provision of appropriate r e ference
materials for the nuroing Department, which
include a Physician's Desk Roforonoo or oompa
rablo drug r e f e r e no e , — policy and prooodure
manual, and medical dictionary for e ach nursing
station; and
establishment of operational procedures to assure
that appropriate suppli e s and e quipment ore
available to nursing staff as d e t e rmin e d — by
individual patient oaro needs.
Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a).
.0506 VACANT DIRECTOR OF NURSING
POSITION
(a) Th e Administrator shall notify the D e partm e nt within
72 hours wh e n th e Director of Nursing position b e com e s
vacant and shall provide the name and license number of the
individual who i e acting Director or the replacement fo r the
Dir e otor of Nursing.
(b) A faoility shall not op e rate without e ith e r a Direotor
of Nursing or acting Director of Nursing.
— (c) The Admini s trator shall employ a Director of Nursing
within 30 day s after a position b e oomoo vaoant. — A vaoanoy
whioh e xceeds 30 days ohall bo reviewed by th e D e partm e nt
for action relative to licensure status of the facility.
Statutory Authority G.S. 13 IE- 104.
.0507 NURSE STAFFING REQUIREMENTS
— (a) — A licensed facility shall provide licensed nursing
personn e l sufficient to accompli oh the following:
(+) pati e nt needs aooooom e nt,
patient oaro planning, and
supervisory function s in accordance with the
levels of patient or r e sid e nt oaro advortiood or
offer e d by the facility.
The facility also shall provide other nursing porsonnol
sufficient to assure that at least activities of daily living,
p e rsonal grooming, restorativ e nuroing actions and oth e r
h e alth oaro needs as id e ntifi e d in e aoh pati e nt's or resid e nt's
plan of care are mot.
— (b) A licensed multi storied facility (one having more than
on e story) shall provid e at least on e person on duty on e aoh
pati e nt oar e floor at all tim e s.
— (e) — Daily direct patient care nursing staff, licensed and
unlicensed, s hall equal or exceed 2.1 nur s ing hours per
pati e nt. (This is som e tim e s referr e d to as nursing hours p e r
pati e nt day or NHPPD or NH/PD.)
(4} Inclusive in tho s e figures i s the requirement that
at least one licensed nurse is on duty for direct
pati e nt oar e at all times; and
<
67
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
(3) Nursing cnro shall include tho services of a
regist e r e d nurse for at least oight oons e outiv e
hours a day, s e v e n days a w ee k. — This ooverag e
can bo spread over moro than one shift if such a
need exists. — The Director of Nursing may b e
oountod ao mooting tho requirem e nt!) for both th e
Dirootor of Nursing and patient and r e sid e nt
staffing for facilities of a total census of 60 bods
or loss.
(5) Nursing — support — personn e l — including — ward
olorka, s e cr e tari e s, nuro e e duoators and p e rsons
in primarily administrative managomont positions
and not actively involved in direct patient care
shall not b e oount e d toward oomplianoe with
minimum daily r e quir e m e nts — for dir e ot oar e
s taffing.
(d) — All exceptions to mooting the minimum staffing
requir e m e nts shall be reported to tho Departm e nt at th e e nd
of e aoh month. — Staffing waivers grant e d by th e f e d e ral
government for Medicare and Medicaid oortifiod bods shall
bo accepted for licen s ure purpose s .
( e ) — Th e ratio of mal e to f e mal e nurse aides will b e
determin e d by tho seeds of th e pati e nts, particularly th e
number s of male patients requiring assistance with personal
Authority G.S. 131E-104; 42 U.S.C. 1396 r (b)(4)(c).
.0510 DOMICILIARY HOME PERSONNEL
REQUIREMENTS
(a) — Tho Administrator shall designate a p e rson to b e in
charge of tho domiciliary homo residents at all times. — The
nurse in charge of tho nursing facility may also servo as
sup e rvisor in oharg e of th e domioiliary hom e or b e d s .
(b) — If domioiliary hom e b e ds ar e located in a s e parate
building or a separate lovol of the same building, there must
bo a person on duty in tho domiciliary homo at all times.
(o) — A lic e ns e d facility shall provide suffici e nt staff to
assure that activiti e s of daily living, p e rsonal grooming, and
assistance with eating are provided to each resident.
Medication admini s tration as indicated by each resident's
condition or phyoioian's orders shall be carri e d out as
id e ntifi e d in e aoh r e sident's plan of oare.
(d) Domiciliary homo facilities (Homo for tho Aged bods)
licensed as a part of a combination facility' shall comply with
th e staffing r e quir e ments of 10 NCAC 42D .H07 as
adopted by th e Social S e rvio e s Commisaion for freestanding
domiciliary homo s .
Authority G.S. 131E-104; 42 U.S.C. 1396 r (a).
.0511 REHABILITATIVE NURSING AND
DECUBITUS CARE
— Eaoh pati e nt or r e sident shall bo giv e n oar e to pr e v e nt
oontraotur e s, d e formiti es , and dooubiti, including but not
limited tet-
— (+) changing positions of bedfast and chairfast patients
or residents ovory two hours and administering
simpl e pr e v e ntiv e oare; — Docum e ntation of such
oar e and outoom e must b e inolud e d in routin e
summarie s or progre ss note s ;
— (¥) maintaining proper alignment and joint movement
to pr e v e nt oontraotures and d e formiti e s, which
must b e documented in routin e summari e s or
progress note s ;
— (£) implementing an individualized bowel and bladder
training program e xo e pt for pati e nts or r e sid e nts
whos e r e oordo ar e dooum e nt e d that ouch training
is not effective; — a monthly summary for patients
and quarterly summaries for domiciliary residents
shall be written relative to e aoh pati e nt's or r e si
dent's p e rformanc e in th e bow e l and bladd e r
training program.
Authority G.S. 131E-104; 42 U.S.C. 1396.
.0512 MEDICATION ADMINISTRATION
(a) A licensed facility s hall have policie s and procedures
gov e rning th e administration of m e dioations which shall b e
e nforc e d and impl e m e nt e d by administration and staff.
Policies and procedures shall include but not be limited to;
(+) automatic stop orders for treatment and drugs;
(3) accountability of controll e d subotano e s as d e fin e d
by th e North Carolina Controll e d Substanc e s
Act, G.S. 90, Article 5;
(3) dispensing and administering behavior modifying
drugs, such as hypnotios, s e dativ e s, tmnquiliz
e rs, antidepressants and oth e r psychoth e rap e utic
agents; insulin; intravenous fluids and modioa
tions; — cardiovascular — regulating — drugs; — aaA
antibiotio s .
(b) — All m e dioations or drugs and tr e atm e nts shall b e
administered and discontinued in accordance with signed
phy s ician' s orders which are recorded in tho patient's or
r e sid e nt's m e dical r e oord.
(44 Only physioions, — r e gist e r ed — nurs e s, — licens e d
practical nurses or physician assistants, if in
accordance with tho assistant's approved prac
tio e , shall administ e r m e dioations.
(3) To e nsur e accountabil i ty, any m e dioation shall
bo administered by tho same licensed personnel
who proparod the dose for admini s tration r
(3) M e dioations shall b e administ e r e d within a h alf-
hour prior to or half hour after th e pr e scrib e d
time for administration unless precluded by
emergency situation s .
(4) The — p e rson — administ e ring — m e dioations — shall
id e ntify' e aoh pati e nt or r e sid e nt in accordanc e
with tho facility's policies and procedures prior
to administering any medication.
($) Medioation(s) administ e r e d to a pati e nt or r e si
d e nt shall bo r e cord e d in th e pati e nt's or r e si '
dent's medioation administration reoord immedi
atoly after administration in accordance with tho
10:2
NORTH CAROLINA REGISTER
April 17, 1995
68
PROPOSED RULES
facility's policies and proooduros.
(4) Omiooion of m e dication s and the r e ason for th e
omiooion ohall b e indicated in th e pationt'o or
roaidont'o modioal record.
(2} The person admini s tering medications which ore
ordered to be givon ao noodod (PRN) shall
juotify the need for th e sam e in the pationt'o or
resident's modioal record.
(8) Medication administration rooordo shall provide
identification of the drug and str e ngth of drug,
quantity of drug administ e r e d, nam e of adminio
toring employee, title of employee and time of
administration.
(o) Self administration of m e dicat i ons shall b e p e rmitt e d
only if proooribod by a phys i cian and dir e ctions ar e printed
on the container.
— -(d-) — The admini s tration of one patient' s or re s ident' s
medications to another pati e nt or resident is prohibited
except in th e eas e of an emerg e ncy. In th e e v e nt of s uch an
emergency, stops shall bo taken to assure that the borrowed
med i cations shall bo r eplaced promptly and so documented.
Statutory Authority G.S. 13 IE- 104.
.0513 ORIENTATION AND STAFF
DEVELOPMENT
— (a) — A lioonsod facility ohall provid e for all pati e nt or
re s ident oaro employees a planned orientation and continuing
education program emphasizing patient or resident assess
m e nt and planning, aotiviti e o of daily living, p e rsonal
grooming, rehabilitative nursing or reotorotiv e oar e , oth e r
patient or resident care policies and procedures, patients'
rights, and staff performance expectat i ons. — Attendance and
s ubj e ct matter cov e red ohall b e docum e nt e d for e aoh s e ssion
and availabl e for lioonouro insp e ctions.
(b) The Administrator shall assure that each employee is
oriontod within the first week of employment to the facility' s
philosophy and goals.
(o) Eaoh e mploy ee shall hav e sp e oifio on th e job training
ao necessary for the employee to properly perform hi s
individual job assignment.
Statutory Authority G.S. 131E-104.
.0514 NURSE AIDE QUALD7ICATIONS
(a) Eff e otiv e Ootobor 1, 1 98 9 a faoility ohall not us e as a
nurs e aid e , any individual not qualifying und e r th e provi
sions of Rule .0515 unless the individual i s within the first
four months aftor being hired.
— (¥) — Nurs e aid e s qualifi e d und e r th e provisions of Rul e
.0515 who oxpori e no e a p e riod of 21 oono e outiv e montho or
more of not being activoly employed in delivering nursing
s ervice s shall bo considered unqualified. — Qualification may
be — reestablished — by — ouoo e oofully — passing an approv e d
comp e tency evaluation. — Any individual, nursing homo, or
education facility may offer Department approved vocational
education for nursing homo nur s e aides.
(o) An accurat e r e cord of nurs e aide qualifications shall
bo maintained for each nurse aide used by a faoility and
shall b e retain e d in the g e n e ral personnel files of the
faoility.
Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396.
.0515 APPROVED NURSE AIDE EDUCATION
— Effective Ootobor 1, 19 8 9 the curriculum content required
for nurs e aid e e duoation programs shall b e subj e ct to
approval by th e Division of Facility S e rvio e o and shall
include, ao a minimum, basic nursing skills, personal care
skills, cognitive, behavioral and social oaro, basic resto r ative
s e rvic e s, and pati e nts' rights. Succ e ssful course complet i on
shall b e determin e d by passing a comp e tency e valuation test.
The minimum number of course hours shall bo 75 of which
at least 20 hours shall bo classroom and at least 40 hours of
sup e rvis e d practical e xp e ri e nc e . — Th e initial orientation to
th e faoility ohall b e e xoluoiv e of the 75 hour training
program. Competency evaluation shall be conducted in each
of the following areas;
— (+) Observation and docum e ntation,
—(3) Baoio nursing skills,
— (3} Personal oare skills,
— {A) Mental health and social service needs,
— {$) Basic r e storativ e s e rvio e o,
— f4) R e sid e nts' Righto.
Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396.
.0516 COMPETENCY EVALUATION
(a) — Suooossful course completion and skill oompotoncy
shall bo determin e d by oompotenoy e valuation approv e d by
the Department.
—(h) — Commencing July 1, 19 8 9, nurse aides who had
formerly boon fully qualified under nurse aide training
r e quirements — H*ay — re establish — th e ir — qualifica tions — by
ouoo e oofully passing a oompot e noy e valuation t e st.
Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396.
.0517 NORTH CAROLINA NURSE AIDE REGISTRY
The function of the North Carolina Nuroe Aide Registry
io to maintain a o e ntral listing of r e gistered nurs e aides.
Eff e otiv e January 1, 1990 t a faoility ohall not p e rmit -aa
individual to work as a nurse aide for a period longer than
four months without verifying the person's registry or
ouoo e ooful compl e tion of an approv e d training progr am^
Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396.
SECTION .0600 - MEDICAL RECORDS
.0605 POLICES AND PROCEDURES
Eaoh lio e no e d faoility ohall hav e polici e s and proc e dur e s
69
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
which shall bo implemented to provide for at loaot the
following:
maint e nance of oompl e to and aoourat e m e dioal
-&h
-&-
records for each patient admitted to the facility;
filing of medical records to ensure aooossibility for
oompiling or r e trieving information f
ouporvioion of medioal reoordo;
Statutory Authority G.S. 13 IE- 104.
.0608 PATIENT INDEX
The Administrator shall assure that a master patient index
is maintained — listing patients alphabetically — by name,
id e ntifying information, dates of admiooion and disoharge
and oas e numb e r.
-(4) confidentiality of records;
-(5) accessibility or non accessibility of medical record Statutory Authority G.S. 131E-104.
information to th e pati e nt or logal guardian,
faoility staff and non e mployees of th e faoility;
retention of records;
— (7) disposition of records; and
— (8) oharting and indexing of records.
Statutory Authority G.S. 13 IE- 104.
.0606 SUPERVISION AND SPACE
— (a) An e mployee who works fulltim e in the faoility shall
bo designated to bo responsible for the modical record
services. — If that employee i s not qualified by training -ef
e xp e ri e no e in modioal rooord soiono e , — he shall r e o e ive
oonoultation from a register e d r e cord administrator or an
accredited record technic i an as determined by noods of the
facility and to assure compliance with wiles contained in this
Subchapt e r.
(b) — M e dioal r e cord work space shall be so locat e d to
assure that records are protected from unauthorized disclo
sure. All modical records shall bo stored in a protected or
sup e rvis e d e nvironm e nt.
Statutory Authority G.S. 131E-104.
.0607 CONTROL AND RETENTION
(a) Medioal reoords shall not b e remov e d from th e faoility
except by oourt order.
(b) The facility's policy relative to retention of modical
reoords shall assure that either the original or a copy of e aoh
pati e nt's or r e sident' s m e dioal r e cord i s r e tain e d in th e
faoility regardless of change of ownership or Administrator
in accordance with North Carolina statutes of limitations for
both adults and minors (G.S.I IS, 1 17).
(o) — A plan for d e struction of m e dioal reoords shall
identify information to be retained and the manner of
de s truction to ensure confidentiality of all material.
(d) Provisions shall bo mad e for a pati e nt or r e sid e nt or
hio l e gal guardian to hav e aoo e s s to th e information oon
tainod in his modical record unless ordered otherwise by the
patient's or resident's physician.
( e ) — Sign e d authorization forms oonoorning approval or
disapproval of r e l e as e of m e dioal information for lio e nour e
inspections shall be a part of each patient's and resident's
modical record. Representatives of the Department shall bo
notifi e d at th e tim e of insp e otion of th e nam e and r e cord
numb e r of any patient or r e sid e nt who has d e ni e d m e dioal
record access to the Department.
.0609 CONTENT OF MEDICAL RECORD
(*) — All entries in the rooord shall bo dated, legible and
signed by the individual making the entry with signature and
titles — If initials are us e d the rooord must oarry a rooord of
e aoh e mploy ee 's full official signatur e and signatur e initials
used in lieu of full signature,
(b) — The patient's or resident's name and case number
must b e r e oord e d on e aoh pag e of th e r e cord,
(o) Th e m e dioal record shall contain at l e ast th e following
information when applicable!
(4) identification data [name, address, ago, box,
marital status, (nam e , addr e ss, and telephon e
numb e r of n e xt of kin, l e gal guardian or both)];
(3) admission data, including modical history and
physical examination ; hospital discharge sum
mary (if th e pati e nt or r e sid e nt io admitted from
th e hospital); admission diagnosis; and rehabili
tation potential, all of which must be signed by
a physician;
(5) transf e r form;
(4) diagnostic r e ports;
($) consultation reports;
(6) physician' s orders which are signed by the
physician;
physician's progr e ss not e s;
modioal and treatment record s , which include
laboratory, x ray, dental examination, physical
th e rapy r e ports, e tc.;
graphio sh ee t;
-m-
medication administration sheet;
— (44-) diabetic shoots;
— (4-3) pati e nt assessm e nt and progr e ss notes by various
disc i plines;
— (45) miscellaneous such as consent and release forra sr
copy of transfer forms to tho receiving institu
tion, disoharge order or release of liability for
th e faoility if th e pati e nt or r e sid e nt l e av e s
against doctor's orders; and
— (44) discharge summary including admitting and final
diagnosis and/or prognosis or oaus e of d e ath.
Statutory Authority G.S. 13 IE- 104.
SECTION .0700 - PHYSICIAN SERVICES
.0705 POLICES AND PROCEDURES
— (a) — Each licensed facility shall have policies and proce
10:2
NORTH CAROLINA REGISTER
April 17, 1995
70
PROPOSED RULES
duroo which arc implemented to assure that the medical or
health oaro of oaoh pati e nt or rooidont io undor the oontinu
ing supervision of a physioian. — Physioian sorvio e s shall
include at least those physician services roquirod in Section
.0300 of this Subchapter.
— (b) — Modioal ordors for all m e dications and tr e atm e nts
administ e r e d to any patient or rooid e nt shall b e sign e d and
dated by the attending physician. All current orders shall be
s igned and dated by the phy s ician at least every 60 days.
— (o) A physioian's oral orders (including t e l e phon e ord e rs)
shall b e giv e n only to a lic e nc e d nurs e or oth e r licensed
professionals who by law aro allowed to accept phy s ician' s
order s , except ordors for therapeutic diets which shall bo
given e ith e r to a qualifi e d di e titian or licensed nurs e . — The
record of oaoh tel e phon e order shall includ e th e nam e of
physician giving the order, date and time of orde r , content
of order and name of person receiving the order. — The
phy s io i an who gives oral ord e rs shall sign th e ord e rs within
fiv e days and in aooordano e with th e facility's writt e n
policies,
(d) Standing ordor s shall bo identified for oaoh patient and
s ign e d by the physioian.
( e ) All di s charg e ord e rs and instructions shall bo oign e d
by a phy s ician.
Statutory Authority G.S. 13 IE- 104.
.0706 ADMITTING PHYSICIAN
The admitting physician shall bo responsible for the
pati e nt' s m e dioal oare until ouch tim e as ord e rs ar e r e c e iv e d
from th e pati e nt's attending physioian.
Statutory Authority G.S. 13 IE- 104.
.0707 EMERGENCY PHYSICIAN
A facility shall designate a physician or physician group
practice to provide emergency services to patients whenever
th e r e gular physioian oannot b e r e ach e d. — Th e nam e and
t e l e phon e numb e r of th e d e signat e d e m e rg e noy s e rvio e
physician or group s hall be po s ted at each nursing station.
Statutory Authority G.S. 13 IE- 104.
.0708 PRIVATE PHYSICIAN
Each patient or legal guardian shall bo allowed to select
hie private physioian except in those faciliti e s affiliat e d with
m e dioal toaohing programs and having writt e n polici e s
requiring all patients to participate in the medical teaching
program.
Statutory Authority G.S. 131E-104.
.0709 DOCUMENTATION
—(a) — Th e phyoioion shall s ee th e pati e nt every 60 day s in
th e nursing faoility. — A physioian visit io consid e r e d tim e ly
if it occurs not late r than 10 days after the date the visit was
required,
(b) Every physioian's visit shall b e documented with an
entry in the physician's notes.
(o) Physioians shall r e vi e w and sign all discharg e summn
ri e s oo r e quir e d by Rul e .060 9 of this Subchapter.
Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a).
.0710 USE OF PHYSICIAN EXTENDERS
The Administrator s hall have on file a current agreement
between the Board of Medical Examiner s and a sponsoring
physioian conc e rning — e aoh physioian aooiotant or nuro e
practition e r visiting pati e nts. — Th e physioian assistant's or
nurse practitioner's privileges in the nur s ing homo must bo
clearly defined by the fac i lity's policies and procedures and
must b e limited to those privileges grant e d by th e Board of
M e dioal Examin efSr-
Statutory Authority G.S. 131E-104.
.0711 BRAIN INJURY LONG-TERM CARE
PHYSICIAN SERVICES
(a) — For nursing facility patients located in designated
brain injury long term oaro units, th e r e shall b e an attending
physioian who io responsibl e for the patient's sp e cialized
care program. — The intensity of the program requires that
there shall bo direct patient contact by a physioian at leas t
ono e p e r week and mor e oft e n as th e pati e nt's condition
warrants. — Eaoh pati e nt's interdisciplinary, r e habilitation
program shall bo developed and implemented undo r the
supervision of a physiatrist (a phy s ician trained in Physical
M e dicin e and R e habilitation) or a physioian of e quivalent
training and experience.
(b) If a physiatrist or physician of equivalent training or
experience is not available on a weekly basis to the facility,
th e faoility shall provid e for w ee kly m e dioal management of
th e pati e nt by another physioian. In add i tion, oversight for
the patient's interdisciplinary, long term care program s hall
bo provided by a qualified consultant phy s ician who visits
pati e nts monthly, mak e s r e comm e ndations for and approv e s
th e interdisciplinary oare plan, and provid e s consultation as
requested to the physician who is managing the patient on a
weekly basis.
—(e) — Th e att e nding physioian shall act i v e ly part i cipat e in
individual ease conferences or oar e planning ooooions and
shall review and sign discharge summaries and records
within 15 day s of a patient discharge. — When patients ore to
b e discharg e d to e ither anoth e r h e alth oar e faoility or a
r e sid e ntial s e tting, the attending physioian shall assur e that
the pationt has boon provided with a discharge plan which
incorporates optimum utilization of community resources
and poet discharg e oontinuity of oar e and s e rvio e s.
Statutory Authority G.S. 131E-104.
.0712 PHYSICIAN SERVICES FOR VENTILATOR
DEPENDENT PATENTS
Nursing facilitie s with ventilator dependent oaro patients
shall contract with a physician who is licensed to practice in
North Carolina with Board C e rtification and who has
t
71
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
facility.
(o) S e rvic e s shall inolud e docum e nt e d on site pharmac e u
tiool r e vi e ws aooomplieh e d at leant every 31 oalondar days
for all patients and residents.
specialized training in pulmonary medicine. — This phyoioian
shall b e rooponoiblo for r e spiratory Qorvioos and ohall:
— (4) establish, with th e r e spiratory therupiot and nuro
«g — staff, — appropriate — ventilator — policies — aad
procoduroa, including omorgoncy procedures;
—(3) assooo e aoh v e ntilator patient' o status at l e ast Statutory Authority G.S. 13 IE- 104.
monthly with corresponding progress not e s;
— (3) bo available on a omorgoncy basis; and
— (4) participate in individual patient care plannin gr
Statutory Authority G.S. 13 IE- 104.
SECTION .0800 - DENTAL SERVICES
.0810 DENTAL EXAMINATION
— A dental examination shall bo performed at the time of
admission with the following information being placed in the
pati e nt's or resid e nt's m e dioal or h e alth oar e r e cord:
— (4} typo of diet whioh th e pati e nt or r e sident oan boot
manage (such as normal, soft or pureed);
—(3) the presence of infection of gums, tooth, or jaws;
(3) briof descr i ptions of any r e movabl e d e ntal appli
onoes and a stat e m e nt of th e ir condition; and
— (4) indications for dental treatment at the time of
admission.
Statutory Authority G.S. 13 IE- 104.
.0811 EMERGENCY DENTAL CARE
Nam e s of d e ntists who have agreed to render em e rg e ncy
dental oare shall b e maintained at eaoh nuroing station and
at the supervisor's station in a domiciliary homo.
Statutory Authority G.S. 13 IE- 104.
.0812 GOOD PRACTICES OF ORAL HYGDZNE
Staff of the facility s hall ensure that!
— (49 n e o e soary doily d e ntal oar e is provid e d;
.0904 PHARMACEUTICAL SERVICES
PROVIDED THROUGH OTHER MEANS
If pharmaoeutiool servic e s ar e provid e d through m e ans
oth e r than by an employee of the facility, th e r e shall b e a
written agreement between the facility and the pharmacist
which shall include the following!
— (4) a statem e nt of th e r e sponsibiliti e s of e aoh part)';
— (3) a r e quirem e nt for th e pharmaci s t to submit to th e
Administrator and the patient's attending physician
written reports of any discrepancies — in drug
accountability or administration.
Statutory Authority G.S. 131E-104.
.0905 ADMINISTRATIVE RESPONSD3ILITDZS
(a) The Administrator shall maintain r e ports of dioor e pan
cio s in drug accountability or drug administration submitted
by the pharmacist and shall make those reports available for
th e Dir e ctor of Nursing and th e Departm e nt's r e pr e sentativ e
for lio e nsuro insp e ction.
(b) — The Admini s trator shall provide documentation of
action taken relative to di s crepancies identified by the
pharmacist whioh shall b e availabl e for lio e nsur e insp e o
Statutory Authority G.S. 131E-104.
.0906 PHARMACEUTICAL SERVICES
COMMITTEE
(a) — The Admini s trator shall appoint a pharmaceutical
o e rvio e s oommitte e whioh shall b e oompos e d of at l e ast th e
-(3) e aoh pati e nt or r e sid e nt possess e s appropriat e pharmacist and d e signated representat i v e s of administration,
nursing and physician s ervice s .
(b) A pharmaceutical services committee shall:
(4) e stablish it e ms and quantities for e m e rg e ncy
toothbrushes and is encouraged and, when ncce e
sary, assisted in their use; and
-&-
e aoh — pati e nt — or r e sid e nt having a r e movabl e
d e ntur e s is furnished a r e c e ptacl e in whioh to
immerse the dentures in water overnight.
Statutory Authority G.S. 131E-104.
SECTION .0900 - PHARMACEUTICAL SERVICES
.0903 AVAILABDLITY OF PHARMACEUTICAL
SERVICES
— (a) — A licensed — facility — shall provide pharmaceutical
services under the supervision of a pharmaci s t currently
lic e ns e d to practic e pharmaoy in North Carolina.
— (b) — A facil i ty shall b e r e sponsibl e for obtaining drugs,
therapeutic nutrients and related products proscribed or
ordered by a physician for patients or residents in the
drug kit;
-(3) moot at least annually and more often as change
in conditions may dictate for reviewing pharm a-
c e utical s e rvio e s; — th e r e shall b e writt e n doou
m e ntation of th e s e r e vi e ws including dat e s,
attendance, busine s s discussed, action taken, and
other relevant matters; — those minutes shall bo
availabl e in th e faoility for at least two y e ars;
-(£) develop and/or approve and annually r e vis e
pharmaceutical policies and procedures;
-(4) approve staff insorvico training de s igned to
improv e staff skills and/or oorroot id e ntifi e d
problems; and
-(5) approve non legend drugs maintained in th e
faoility and a written formulary for same.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
72
PROPOSED RULES
(c) Tho pharmacist ahnll bo a member of the pharmao eMti-
ool sorvioos oommittoo and shall part i c i pate in drug utilize
tion review and report to th e oommitto e at l e ast annua Hy-en
tho status of tho facility's pharmaceutical services and staff
porformnnco.
Statutory Authority G.S. 13 IE- 104.
.0907 DRUG PROCUREMENT
—(a) — Nursing homoo shall not b e p e rmitt e d to possess a
stock of proscription l e g e nd drugo for g e n e ral or oommon
use except as permitted by tho North Carolina Board of
Pharmacy and as follows:
fi) for all intrav e nous and irrigation solutions in
single unit quantities e xoooding — 19 ml. Bad
related equipment for tho use and administration
of such;
(3) diagnostic agon to;
-(4)-
vaooin e c;
drugs des i gnated for inclusion in an approved
emergency kit;
{§} water for injection; and
-&h
normal salin e for inject i on.
(b) Patient Drug s .
£±} Tho contents of all proscriptions shall bo kept in
th e original oontainor bearing tho original lab e l
as d e scrib e d in (b)(2) of thi s Rul e .
(3) Except in unit dose systems, each individual
patient's or resident's proscription or legend
drugs shall b e lab e l e d with tho following infor
motion:
(A) — tho name of tho patient for whom tho drug i s
intended;
(B) — th e moot r e c e nt date of issu e ;
(€) — tho name of the prosorib e r;
(©) — tho name, concentration of the drug, quantity
dispensed, and proscription sorial number;
(E) — a statem e nt of g e n e ric e quival e ncy which shall
b e indicat e d if a brand other than th e brand
proscribed is dispensed;
(F) — the expiration date and other auxiliary state
m e nto as requir e d of th e drug;
(G) — th e nam e , addr e ss and tel e phon e numb e r of th e
dispensing pharmacy; and
(H) — tho name of tho dispensing pharmacis ts
Statutory Authority G.S. 13 IE- 104.
.0908 DRUG STORAGE
(a) Exc e pt for e m e rg e ncy drug kit and properly s e cured
modioation oarts, all proscription or legend drugs shall be
stored in a locked room or locked wall cabinets except whon
tho drugs are under tho immed i ate, direct physical supervi
oion of a lio e no e d nurse or pharmacist. — Non l e g e nd or
non pr e ooription drugs shall b e stored in an area whioh is
locked whon not in use and aooossiblo only by authorized
individual s .
—(b) — Em e rgenoy drug kit shall b e stor e d in a r e asonably
secure area out of tho sight of patients and tho general
public
(o) — Drugo requiring rofrigoration shall b e stored in a
thermometer equipped refrigerator capable of maintaining a
temperature range of 2!C. to 8 !C. (36!F. to 4 5!F.), Drug s
shall not be stored in a refrigerator containing non drugs
and non drug related items, e xo e pt wh e n stored in a separate
looked containe r .
(d) — Drugs intended for topical use shall bo stored in a
d e signated area separate from drugs intend e d for oral and
inj e ctabl e us e .
(o) Tho pharmacist shall remove outdated and deteriorated
drugs from tho facility within 30 days after their period of
e ff e ctiveness has lapsed.
Statutory Authority G.S. 131E-104.
.0909 PHARMACEUTICAL RECORDS
Th e pharmacist shall aooure that accurat e r e cords of th e
receipt, use and/or other disposition of drugs are maintained
and readily available.
Statutory Authority G.S. 13 IE- 104.
.0910 EMERGENCY DRUGS
(a) — Th e facility shall maintain a supply of e morgoooy
drugs.
—(b) — Emergenoy drugs shall bo stored in a portable
oontainor sealed with an easily breakable closure which
cannot be reooalod and shall b e r e adily aoooosiblo for uoo.
(o) — All e merg e noy drugs and quantity to b e maintain e d
shall bo approved by tho pharmaceutical services oommittoo.
(d) If emergency drag items require refrigerated storage,
th e y shall b e stored in a separate s eal e d contain e r within th e
m e d i cation r e frig e rator. — Th e contain e r shall be label e d to
indicate tho emergency status of tho enclosed drug(s) and
sealed as indicated in Paragraph (b) of this Rule.
( e ) — An aoourate inventory of emergenoy drugs and
suppli e s shall b e maintained with oaoh emerg e noy drug kit.
(0 The pharmaci s t shall personally examine tho refrigor
atod and non refrigerated eme r gency drug supply at least
e very 90 days and mak e any necessary ohong e s at that tim e .
(g) Th e faoility shall hav e writt e n polioi e o and procedures
which are enforced to assure that in tho event tho sealed
emergency drug container is opened and contents utilized,
imm e diate st e ps ar e tak e n to r e plac e th e items us e d.
— (4») — Th e availability of a controlled substance in an
omorgoncy drug kit shall bo in compliance with current state
and federal laws.
Statutory Authority G.S. 13 IE- 104.
.0911 DRUG DISPOSITION
(a) Upon d i scharg e of a patient or resident, tho remainder
of his drug supply shall b e dispos e d of promptly unl e ss it is
reasonably expected that tho patient or resident shall return
to tho faoility and in such case, tho remaining drug supply
may b e h e ld for not mor e than 30 oal e ndar days aft e r th e
♦
73
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
dato of discharge.
(b) The diopooition of drugo ohall b e in aooordano e with
written polioi e o and proo e dur e o e otabliohod by th e pharmn and s e rv e d ao ord e r e d. — Th e modioal r e cord ohall oontain
.1004 DIETS
(a) All di e to ohall bo proooribod by the pati e nt' o phyoioian
nutritional assessments and progress no too that include!
(+) diet hiotory and observation of food intake;
coutical sorvicos oommittoo.
— (e) — Accurate rooordo of drug destruction shall bo main -
tained and authenticated by tho pharmaoist and Dir e otor of
Nursing.
(d) Controlled s ubstanoos shall bo dootroyod in accordance
with provisions of tho North Carolina Controlled Substances
Aot, G.S. 90, Artiol e 5.
Statutory Authority G.S. 131E-104.
SECTION .1000 - DIETARY SERVICES
.1003 ORGANIZATION
(a) — Tho Admini s trator shall de s ignate a person to bo
known as th e food sorvioo supervisor who s hall be rosponsi
bio for th e nursing hom e 's di e tary o e rvio e and di e tary
s ervice personnel. — If this person is not a qualified dietitian,
ho must have successfully completed a course which would evening meal containing a protein food and a morning meal
— (3) aooooomont of body weight and form and di e tary
r e quir e ments; and
— (3} notes of counseling of patients and family ?-
-fb) — Documentation of menus served shall reflect that!
— (4-) r e gular di e t piano moot nutritional Heeds of tho
pati e nts — in aooordano e — with ourrent — reoom
mended dietary allowances of tho Food and
Nutrition Board, National Research Council and
ar e adjust e d to ag e , sex and act i vity; and
(3) therapeutic diet plans moot nutritional standards
as stated in (bXl) of this Rule to the extent that
is medically possible,
(o) — At least throe meats shall bo served daily to all
pati e nts and r e sid e nts.
— (d) No more than 1 4 hours s hall e lapse between an
qualify' him for membership in the Dietary Manag e rs
Association. — If th e oouro e has not boon oompl e t e d, this
per s on must bo enrolled in a course and making sati s factory
progress for completion within tho time limit specified by
oouro e r e quir e m e nts.
(b) — If th e food oorvioo supervisor is not a qualifi e d
diotitian, tho Administrator shall provide for a minimum of
eight hours per month consultation from a qualified dietitian
or sufficient time to aooure that therapeut i c diets are planned
and s e rv e d in aooordano e with th e physician's ord e rs. — The
consultant shall submit written reports to the Administrator
and food sorvioo supervisor. — The reports will bo kept on
fil e in th e faci l ity for at l e ast two y e ars.
— (e) — Tho food oorvioo superv i sor shall b e r e sponsibl e for
tho total operation of tho dietary Department. — This respon
sibility shall include coordinating dietary services with other
faoility sorvioos; developing writt e n job descriptions; food
purchasing; d ie tary staff ori e ntation, training and suporvi
sion of dietary employees; participation in patient caro
conferences; implementing current policies and procedure s ;
and maintaining a ourr e nt r e cord of diet order for each
pati e nt or resident who shall b e id e ntified by name, room
and bod number and diet order.
— (d) Dietary personnel shall bo employed and scheduled to
m ee t tho nutritional need s of all pati e nts and r e sid e nts.
( e ) Th e kitchen ohall bo staff e d by at least one person for
twelve consecutive hours, breakfast through supper.
(f) Duty assignments of dietary personnel shall bo posted
and shall bo availabl e to staff at all timeo.
(g) — Dietary omployooo ohall participat e in in s e rvioo
e ducation which shall include but not bo limited to thorapou
tic diets, food preparation requ i rements, and principles of
sanitation.
Statutory Authority G.S. 13 IE- 104.
containing a protein food.
—(e) — Betw ee n meal nourishm e nts ohall b e availabl e and
offered to all patients and residents.
(f) If a therapeutic diet require s a specific between moal
nourishm e nt, docum e ntation shall aoour e th e gam e was
served or off e r e d and r e fus e d by th e pati e nt or r e sident.
(g) — An up to date manual approved by tho diotitian,
medical staff, and tho Administrator s hall bo used in tho
planning of regular and therapoutio diets.
(h) M e nus ohall b e dated and plann e d at l e ast thr ee weeks
in advance for both regular and therapeutic diets. — They
shall bo posted in tho kitchen and accessible to kitchen s taff-
All m e nus shall b e corrected as served and k e pt on fil e in
th e faoility for a minimum of one year from th e date served.
(i) Food must bo prepared to conserve its nutritive value
and appearance.
— (j) — Unless medically contra indicat e d. — foods shall b e
s e rv e d at th e temp e ratur e or t e mperature range specified in
tho diet manual, recipe, or package instructions, and in a
consistency and texture to moot individual needs. — Hot food
shall be serv e d hot and oold foods served oold and in a
consist e ncy to m ee t individual ne eds? — If pati e nts or r e si
dents require assistance in eating, food shall bo maintained
at s erving temperature until assistance is provided.
(k) — Patients' and resid e nts' food pr e f e r e nc e s must b e
considered. However, wh e n food is substitut e d it must b e of
a similar nutritive value as that for which it i s substituted.
Statutory Authority G.S. 13 IE- 104.
.1005 FOOD SUPPLIES
The following supplies must bo available in tho facility at
all times and suffici e nt to moot nutritional needs of tho
pati e nts and r e sidents:
— (+) non perishable food sufficient for a 3 day period;
10:2
NORTH CAROLINA REGISTER
April 17, 1995
74
PROPOSED RULES
— (2) perishable food gufficiont for a 2 4 hour period.
Statutory Authority G.S. 131E-104.
.1006 RECORDS
Tho Adminiotrator shall maintain th e following records for
at l e ast one year:
— (4-) a record of all food and supplie s purchases show
ing quantities and total co s t of all items purchased;
— (3) daily m e al census (staff as w e ll as pationto and
r e sid e nts); and
— (3) labor costs for providing dietary s ervice s .
Statutory Authority G.S. 131E-104.
.1007 DINING FACILITIES
Patients, including wheelchair patients, shall bo oncour
aged to eat at th e tabl e s in th e dining ar e a and assisted wh e n
nooossary by non dietary staff. — An ov e rbod table shall be
provided for pationta who oat in bod. — A sturdy tray stand
shall bo provided for those patients who oat out of bod but
ar e unabl e to go to th e dining ar e a. — (An ov e rb e d tabl e
which oan b e low e r e d to ohair h e ight may substitute for th e
tray stand.)
Statutory Authority G.S. 131E-104.
.1008 SANITATION
(a) Food services shall comply with tho most current rules
for sanitation ao promulgated by th e Commission for Health
Sorvioos.
— (b) — All facilities shall maintain a "Grade A" sanitation
rating. If tho grade fall s below an "A", the Administrator
shall notify' th e D e partm e nt within T e n days. — This notifioa
tion shall includ e a oopy of th e sanitation insp e ct i on r e port
with a plan for corrective action which the facility shall
accomplish within 90 days.
— («) — Reports of sanitation insp e ctions and a r e cord of
correctiv e aotion for any defioienoies not e d shall b e on fil e
in tho dietary Department and maintained for at least two
years.
(d) — Polici e s and proo e dur e o shall b e d e v e lop e d and
implemented to assure that dishes and ut e nsils from patients
with communicable diseases are isolated until sterilized or
destroyed.
— (e) — Cl e aning soh e dulos and instructions for cleaning b H
e quipm e nt and work and storag e ar e as shall b e post e d in th e
dietary area and accessible to all dietary staff.
— (f) Employees with infectious or communicable diseases
shall not work in dietary s e rvic e s.
(g) — A lioensod faoility must hav e a writt e n plan for
sanitizing dishes, such ao chomioal washing, in case of
disasters, or malfunctioning of equipment.
Statutory Authority G.S. 13 IE- 104.
SECTION .1100 - SPECIALLY DESIGNATED
UNITS
. 1 1 05 REQUIREMENTS FOR SERVICES
— Sp e cialized rehabilitative and habilitativ e sorvioos, suoh as
physical therapy, occupational therapy and speech therapy,
are not required as a condition of licensure. — However,
pati e nts r e quiring ouoh s e rvic e d shall not b e admitted to nor
r e tain e d in a faoility unl e ss th e faoility is capabl e of furnish
ing tho Doodod sorvioo through faoility staff and equipment
or through contractual arrangement. — If phy s ical therapy,
occupational th e rapy, or spoooh th e rapy ar e provided:
— (4-) A physioian's order for sorvioos shall b e r e cord e d
in tho patient' s or resident's rooord.
— (2) The facility shall provide adequate space and
appropriat e e quipm e nt — for rendering physical
therapy or oooupational therapy sorviooo required
by patients or residents in tho facility.
— (3} Tho sorvioos shall bo superv i sed by a therapist
duly lic e ns e d or oortifiad to praotioe in th e ar e a
sup e rvised.
— (4) Tho thorapist shall incorporate his note s pertaining
to treatment in tho patient' s or resident's medical
or h e alth car e r e cord.
— (£) Th e therapist's notes shall b e availabl e for physi
cian review.
Statutory Authority G.S. 13 IE- 104.
. 1 106 QUALITY OF SPECIALIZED
REHABILITATION SERVICES
(a) Whil e the person sup e rvising sp e cializ e d r e habilitativ e
and habilitativ e s e rv i c e s shall b e a duly lio e nsed or oo rtifiod
professional thorapist, all other support personnel shall bo
trained in tho area of assignment and directly supervised by
th e th e rapist in th e ar e a of assignm e nt.
(b) S e rvio e s provided through outside rosouroeo shall bo
carried out through and in accordance with written agree
monts.
(o) — Sorvioos shall b e d e sign e d to maintain and improv e
th e pati e nt's or resid e nt's ability to funotion independently,
prevent as much as possible tho advancement of progressive
disabilities, and restore maximum function.
— (d) If nuroing staff oany out se le cted therapy procedures,
th e y shall do so und e r th e sup e rvision of th e physical or
occupational thorapi s t and only after documented training
and approval by tho thorapist. — Thi s is not to prohibit simple
restorativ e m e asur e s by th e nursing staff.
Statutory Authority G.S. 131E-104.
.1107 VENTILATOR DEPENDENCE
Th e g e n e ral r e quir e ments in this Subchapt e r shall apply
when applicable. — In addition, facilities having patients
requiring tho use of ventilators for more than eight hours a
day must moot the following requirements:
— (44 Th e faoility must bo located within 30 minutes of
an acute care facility.
— (2) Respiratory therapy shall bo provided and super
visod by a r e spiratory th e rapist ourr e ntly r e gis
I
75
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
torod by tho National Board for Re s piratory Care.
Th e r e spiratory therapist ohall:
— (a) mak e , ao a minimum, wookly on sit e ass e ss
monta of each patient receiving ventilator sup
port with corresponding progress notoo;
— (b) b e on oall 24 hours daily; an d
— (e) assist th e pulmonologiot and nursing staff in
establishing ventilator policies and procedure s ,
including emergency policies and procedures.
-(3) D i rect nur s ing oar e staffing shall b e in aooordano e
with 10 NCAC 3H . 1 109.
Statutory Authority G.S. 131E-104.
. 1 108 BRAIN INJURY LONG-TERM CARE
—(a) — Tho general requirements in this Subchapter shall
apply when applicable, but brain injury long term care units
ohall m ee t th e suppl e m e nt r e quirem e nts in Rul e s . 1 10 8 and
.1109 of this S e ction. — Brain injury long term oar e is an
interdi s ciplinary, intensive maintenance program for patients
who have incurred brain damage caused by external physical
trauma and who hav e oompl e t e d a primary oouro e of
rehabilitative treatment and have roooh e d a point of no gain
or progress — for more than throe — consecutive — months.
Services are provided through a medically — super . 1 i sod
interdisciplinary prooooo as provid e d in Rul e .07 1 1 of this
subchapter and are direoted toward maintaining th e individ
ual at tho optimal level of phys i cal, cognitive and behavioral
functionin g^ — Following are the minimum requirements for
sp e oifio servic e s that may b e necessary to maintaining th e
individual at optimum l e v e l:
(1) Overall — supervisory — responsibility — for brain
injury long term care services s hall bo assigned
to a r e gist e red nurs e with one year exp e ri e nc e in
oaring for brain injur e d pati e nts.
(3) Physical therapy shall bo provided by a phy s ical
therapist with a current valid North Carolina
lic e nce. Occupational th e rapy shall bo provided
cal nutrition services shall include;
-(A) — Assessing th e appropriatenooo of th e ord e r e d
di e t for conformanc e with oaoh patient's phyoi
ological and pharmacological condition.
-(B) — Evaluating oaoh patient's laboratory data -in
r e lation to nutritional status and hydration.
Applying — t e ohnioal — knowl e dg e — of feed i ng
-(G)-
tubes, pumps and equipment to oaoh patient's
specialized needs.
-(4) Clinical socia l work shall b e provided by a
oooial workor mooting th e r e quir e m e nts of Rule
.1306 of this Subchapter.
Recreation therapy, when required, shall bo
-&-
provid e d on e ith e r a full tim e or part time
e mploym e nt or oontract basis by a clinician
eligible for certification as a therapeut i c rocro
ation specialist by tho State of North Carolina
Th e rap e utio R e cr e ational Certification Board.
Th e number of hours of th e rapoutio r e or e ation
service s shall bo adequate to moot tho needs of
tho patients. In event that a qualified specialist
is not looally available, — alt e rnat e tr e atment
modalitioo ohall b e developed by th e oooupa
t i ona l therapist and reviewed by tho attending
physician. Tho program dooignod must bo
adequate to moot tho needs of this specialized
population and must b e administered in aooor
dance with Section .1200 of this Subchapter.
(6) Speech therapy, when r equired, shall bo pro
vid e d by a clinician with a current valid license
in opoooh pathology iooued by tho Stat e Board of
Audiology and Speech pathology.
(2) Respiratory therapy, when required, s hall bo
provid e d by an individual mooting the oumo
qualifications for providing r e spiratory thoropy
under Rule . 1 107 of this Section,
(b) — Each patient's program shall bo governed by an
interdisciplinary treatm e nt plan incorporating and e xpanding
by an occupational th e rapist with a ourront valid upon tho health plan r e quir e d under Section .0100 of this
North Carolina licen s e. — Tho services of a
physical therapist and occupational therapist shall
Subchapter. — The plan is to bo initiated on tho first day of
admission. Upon completion of baseline data development
b e oombin e d to provide one full tim e e quival e nt and an int e grat e d interdisciplinary assessm e nt th e initial
position for oaoh 20 pati e nts. — Th e assistano e of
a physical therapy aide and occupational therapy
treatment plan is to b e e xpand e d and finaliz e d within -44
days of admi s sion. Through an interdisciplinary proces s tho
aido, with appropriate supervision, shall bo treatment plan shall bo reviewed at least monthly and
oombin e d to provid e one full tim e e quivalent
position for oaoh 20 pati e nts. — A proportionat e
number of hour s shall bo provided for a census
loss than 20 patients-
r e vis e d as appropriate. — In e x e cuting tho tr e atm e nt plan th e
int e rd i sciplinary t e am ohall b e the major deoioion making
body and shall determine tho goals, process, and time
frames for accomplishment of each patient's program.
-(3) Clinioal nutrition oorvioos shall bo provid e d by Diociplin e o to b e represented on th e t e am ohall b e m e d i cin e ,
a qualifi e d diotioian with two y e ars elin ieal-
tmining and experience in nutrition. — Tho num
bor of hours of clinical nutrition oorvioos on
e ith e r a full tim e or part tim e e mployment or
contract basis shall be ad e quate to moot tho
needs of tho patients. — Each patient's nutrition
needs shall bo reviewed at least monthly. — Clini
nursing, clinioal pharmacy and all other disciplines d i rectly
involved in tho patient's treatment or treatment plan.
(c) Each patient's overall program shall be a s signed to an
individually designat e d oao e manag e r. — Th e oas e manage r
aoto ao th e coordinator for assign e d pati e nts. — Any profos
sional staff member involved in a patient's oare may bo
assigned this responsibility for one or more patients.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
76
PROPOSED RULES
Professional staff may divide this responsibility for all
patients OB th e unit in the boot manner to moot all pati e nts'
noods for a coordinated, interdisciplinary approach to oar e .
Tbo case managor shall bo responsible for;
(4-) coordinating tho dovolopmont, implementation
and p e riodio revi e w of the patient's tr e atm e nt
(3) preparing a monthly summary of tho patient's
progress;
(3) cultivating — tho pati e nt'o participation — in th e
program;
(4) general supervision of tho pationt during tho
course of treatment;
(5) e valuating appropriatonooo of tho treatment plan
in relation to tho attainm e nt of otnted goals; and
(6) assuring that discharge decisions and arrange
roonto for post discharge follow up arc properly
— -(d) — For e aoh 20 pati e nto or fraotion th e r e of, d e dicated
treatment facilities and equipmoDt shall bo provided as
follows:
(4) A combin e d th e rapy space oqual to or oxoooding
600 square foot, ad e quat e ly e quipp e d and ar
ranged to support each of the therapies;
(3) Access to ono full reclining wheelchair per
pati e nt.
(3) Special phyGioal th e rapy and occupational thor
apy equipment for use in fabricating positioning
device s — for bods and wheelchairs — including
splints, oastc, oushions, wodgoo, and bolsters.
(4) There shall b e roll in bath faoiliti e o with a
dressing area available to all patients which shall
afford maximum privacy to tho pationt.
Statutory Authority G.S. 13 IE- 104.
. 1 109 SPECIAL NURSING REQUIREMENTS FOR
BRAIN INJURY LONG-TERM CARE
Direot oar e nursing p e roonn e l staffing ratios established in
Section .0500 of this Subchapter shall not bo applied to
nursing services — for patients who require brain injury
long term oare, du e to th e ir more intensiv e maintenanc e and
nursing needs. Th e minimum dir e ot oar e nursing staff shall
bo 5.5 hours per pationt day, allocated on a por shift basis
as tho facility chooses, to appropriately moot tho patients'
n ee ds. — It iG also roquirod that rogardloGO of how low tho
patient census, th e dir e ot care nursing staff shall not fall
below a registered nur s e and a nurse aide I at any time
during a 2 4 hour period.
Statutory Authority G.S. 131E-104.
.1130 ADMISSIONS TO THE HTV DESIGNATED
UNIT
If a faoility declin e s admission to a pationt known to have
Human Immunodeficiency Virus disease, tho reasons for tho
denial shall bo documented.
Statutory Authority G.S. 131E-104.
.1131 HIV DESIGNATED UNIT POLICES AND
PROCEDURES
— (a) In addition to Rule .0314 of this Subchapter, in units
dedioatod — te — the — tr e atm e nt — of patiento — with — Human
Immunodofioionoy Virus diooaoo, polici e s and proo e duroo
specific to tho specialized needs of tho patiento served shall
bo developed. At a minimum they shall include staff
training and e ducation, and th e availability of consultation
by a physioian with sp e cialized eduoation or knowl e dg e in
tho management of Human Immunodoficioncy Virus disease,
(b) Policies and procedures for infection control shall bo
« — conformance with 29 CFR 1910 (Occupational Safety
and H e alth Standards) whioh is incorporated by reforonoo
including subsequent amendments. Emphasis shall be
placed on compliance with 29 CFR 1910 1030 (Bloodboumo
Pathog e ns). Copi e o of Titl e 29 Part 1910 may b e purchas e d
from the Superintendent of Dooumonto, U.S. Gov e rnm e nt
Printing Office, Washington, D.C. 20 4 02 for $38.00 or may
bo purchased with a credit card by telephone to tho Govern
m e nt Printing Offio e at (202) 7 8 3 323 8 . Inf e otion control
s hall al s o b e in compliance with th e C e nter of Disease
Control Guideline s as publi s hed by tho U.S. Department of
Health and Human Sorvicoe, Public Health Sorvioo which is
incorporated by ref e reno e including subs e quent aro e ndm eBter
Copi e s may b e purohasod from th e National T e chnical
Information Sorvioo, U.S. Department of Commerce, 52 8 5
Port Royal Road, Springfield, Virginia, 22161 for $15.95.
Statutory Authority G.S. 131E-104.
.1132 PHYSICIAN SERVICES IN A HTV
DESIGNATED UNIT
In faciliti e s — with a Human Immunod e fioi e noy — Virus
designated unit, tho facility shall insure that attending
physicians have documented, pro arranged aooooo in person
or by tel e phon e to a physioian with sp e cializ e d e duoation or
knowledg e in th e management of Human Immunodofioionoy
Virus Disoaoo.
Statutory Authority G.S. 13 IE- 104.
. 1 133 SPECIAL NURSING REQUTCEMENTS FOR
A HTV DESIGNATED UNIT
— (a) — Faoilitieo with a Human Immunodefioienoy Virus
designated unit shall hav e a registered nurs e with specialized
eduoation or knowledge in tho care of Human Immunodofi
cioncy Virus disease.
(b) Nursing p e roonn e l assign e d to th e Human ImmunG de-
fioi e noy Virus unit shall b e r e gularly assign e d to th e unit.
Rotations are acceptable to olloviato staff burnout or staffing
emergencie s .
Statutory Authority G.S. 13 IE- 104.
.1134 SPECIALIZED STAFF EDUCATION FOR
HTV DESIGNATED UNITS
77
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
For facilitioo with a Human Immunodeficiency Virus
dooignatod unit, an organized, dooumonted program of
oduoation opooifio to th e cor e of pati e nts infected with th e
Human Immunodeficiency Virus shall bo provided and
include at a minimum:
— (4) Human Immunodofioi e noy Virus and Acquir e d
Immune Dofioi e noy Syndrom e diooaoo prooooooo;
— (3) transmission modes, oauoos, and prevention of
Human Immunodeficiency Virus;
—(39 tr e atm e nt of Human Immunodofioienoy Virus and
Aoquired Immune Dofioienoy Syndrom e ;
— (4) psycho socio economic — needs — &f- — the — Human
Immunodeficiency Virus and Acquired Immune
Dofioienoy Syndrom e pati e nts;
— (5} univ e rsal pr e cautions and infection oontrol; and
— (6} policie s and procedures specific to the Human
Immunodeficiency Virus designated unit.
Statutory Authority G.S. 13 IE- 104.
.1135 USE OF INVESTIGATIONAL DRUGS FOR
HTV DESIGNATED UNITS
— (a) The supervision and monitoring for th e administration
of investigational drug s i s the r esponsibility of the pharma
cist and a licensed registered nurse, acting pur s uant to the
orders of a physioian duly authoriz e d to proscribe or
dispense such drugs. — Responsibiliti e s shall includ e , but not
bo limited to, the following!
(4) insuring the provision of written guidelines for
any inv e stigational drug or study ar e provided;
(3) training and determination of staffs abilities
regarding admini s tration — of drug s , — policies,
proc e dures and r e gulations.
(b) Th e pharmacist or physioian disp e nsing th e inv e stiga
tional drug is to provide the facility with information
regarding at least the following!
(4) a copy of the protocol, includ i ng drug inform a-
(2) a copy of the patient's informed consent;
(3) drug storage;
-(4) handling;
(§} ftfiy — sp e oifio — pr e paration — and — administration
instructions;
(6) specific detail s for drug accountability, rosupply
and r e turn of unus e d drug; and
(7) a copy of the signed oonoont to participat e in th e
study.
—(e) — Lab e ling of investigational drugs shall bo in aocor
danc e with writton guidelin es of protocol and State and
f e d e ral r e quirements r e garding suoh drugs. — Proscription
labels for inve s tigational drugs are to bo distinguishable
from other label s by an appropriate legend, "Investigational
Drug" or "For Investigational Us e Only".
Statutory Authority G.S. 131E-104.
.1136 ADDITIONAL SOCIAL WORK
REQUHtEMENTS FOR HTV DESIGNATED
UNITS
In addition to the social work services specified in Rule
.1307 of this Subchapter, — in facilities with a Human
Immunod e fici e ncy Virus diooaoo designated — unit, th e oooial
work e r shall provid e or arrang e for th e provision of spiri
tual, pastoral and grief counseling and bereavement service s
for patients and staff whore appropriate. — Support service s
shall b e provided to r e sid e nt famili e s and significant others.
Wh e r e n e o e ooary, coordination with tr e atm e nt s e rvic e s for
substance — abuse, — legal — services — and other community
re s ources s hall bo identified.
Statutory Authority G.S. 13 IE- 104.
.1150 DEFINITIONS
Th e following definitions shall apply to inpatient rohabili
tat i on faciliti e s or units only:
— (4) "Case management" moans the coordination of
services, for a given patient, between di s cipline s
so that th e pati e nt may r e aoh optimal rehabilitation
through th e jud i cious use of rooourooo.
— (2) "Comprehensive, inpatient rehabilitation program"
moans a program for the treatment of persons with
functional limitations or ohronio disabling oondi
tiono who hav e th e potential to achi e v e a signifi
cant improvement in activities of daily living : — A
comprehensive, rehabilitation program utilizes a
ooordinated — and — integrated, — interdisciplinary
approaoh, dir e ct e d by a physioian, to ass e ss
patient needs and to provide treatment and ovalua
tion of physical, — psycho s ocial — and cognitive
d e ficits.
— (3) "Inpati e nt rehabilitation faoility or unit" means a
free standing facility or a unit (unit pertains to
contiguous dedicated bods and space s ) within an
e xisting lioonood health sorvioo faoility approv e d in
accordanc e with G.S. 13 IE, Articl e 9 to es tablish
inpatient, rehabilitation bods and to provide a
comprehensive, inpatient rehabilitation program.
— (4) "M e dioal consultations" moans consultations whioh
th e rehabilitation physioian or th e att e nding physi
cian determine are necessary to moot tho acute
medical needs of the patient and do not include
routin e modioal needs.
— (5) "Occupational th e rapist" m e ans any individual
licensed in tho State of North Carolina as an
occupational — therapist in accordance with tho
provisions of G.S. 9 0, Artiole 1 8 D.
—(6) "Occupational — therapist — assistant" — m e ans — any
individual licen s ed in tho State of North Carolina
as an occupational therapist assistant in accordance -
with the provisions of G.S. 9 0, Artiol e 1 8 D.
"Psychologist" m e ans a p e rson lic e ns e d as a
practicing psychologist in accordance with G.S.
90, Article 1 8 A.
-(74-
10:2
NORTH CAROLINA REGISTER
April 17, 1995
78
PROPOSED RULES
-W-
■m-
■iW-
-w-
-QZh
<m-
-tf4)-
"Phyoiatri e t" means a licensed physician who has
oomplotod a physioal m e dioin e and rehabilitation
r e sid e ncy — training — program — approved — by — the
Accroditing Council of Graduate Modioal Educa
tion of tho American Osteopathic AsBociation.
"Physical therapist" m e ans any p e rson lio e no e d in
the State of North Carolina as a phyoioal th e rapist
in accordance with tho provisions of G.S. 90,
Article 18B.
"Phyoioal th e rapist assistant" m e ans any p e rson
lioono e d in th e State of North Carolina ao a phyoi
cal therapist assistant in accordance with the
provisions of G.S. 90 270.2 4 , Article 1 8 B.
"Rooroationol th e rapist" moans a person o e rtifi e d
by th e State of North Carolina Th e rap e utio R e ore
ational Certification Board.
"Rehabilitation nurse" moans a registered nurse
licens e d in North Carolina, with training, e it hef
aoad e mio or on th e job, in phyoioal rehabilitation
nursing and at least one year experience in physi
cal rehabilitation nursing,
"Rehabilitation aide" means an unlio e no e d assistant
who works und e r th e sup e rvision of a registered
nuroo, lioonsod physioal therapist or occupational
therapist — m — aeoordan ee — w+tb — tho appropriate
occupational lio e nour e laws gov e rning his or h e r
sup e rvisor and consistent with staffing r e quir e
moots as sot forth in Rule .1157 of this Section.
The rehabilitation aide shall bo listed on tho North
Carolina Nurs e Aid e R e gistry and hav e roooivod
additional staff training as list e d in Rul e . 1 15 8 of
this Section.
"Rehabilitation physician" moans a physiatrist or
a phys i cian who io qualified, based on education,
training and e xp e ri e nc e r e gardlooo of sp e cialty, of
providing modioal caf e to rehabilitation patients.
(15) "Social worke r " means a person certified by tho
North Carolina C e rtification Board for Social
Work in aooordano e with G.S. 90 B 3.
(16) "Speech and language pathologist" moan s any
person licensed in tho State of North Carolina as
a opocoh and languag e pathologist in aooordano e
with th e provisions of G.S. 90, Artiol e 22.
Statutory Authority G.S. 13 IE- 104.
.1151 PHYSICIAN REQUIREMENTS/INPATIENT
REHABILITATION FACILITIES OR UNITS
(a) — In a rehabilitation facility or unit a physician shall
participate in th e provision and manag e m e nt of rehabilitation
s e rvic e s and in tho provision of m e dical sorvioos.
(b) — In a rehabilitation facility or unit a rehabilitation
physician shall bo responsible for a pationt's intordisciplin
ary tr e atm e nt plan. — Eaoh pati e nt's int e rdisciplinary tr e at
ment plan shall be developed and impl e m e nt e d und e r th e
supervision of a rehabilitation physician.
(o) — Tho rehabilitation physician shall participate in tho
pr e liminary assooomont within 4 8 hours of admission,
prepare a plan of oaro and direct the noooooary frequency of
contact based on th e m e dioal and rehabilitation needs of the
pati e nt. — Th e fr e quenoy shall b e appropriat e to justify th e
need for oomprohonsivo inpatient rehabilitation care.
(d) An inpatient rehabilitation facility or unit's oontmot o r
agre e m e nts with a rehabilitation phyoioian shall r e quire that
th e rehabilitation physician shall participat e in individual
case conferences or care planning sessions and shall roviow
and 3ign discharge s ummaries and records. — When patients
ar e to b e discharg e d to anoth e r health car e facility, th e
discharging facility shall assure that th e pationt has boon
provided with a discharge plan which incorporates post
discharge continuity of care and services. When patients are
to b e discharg e d to a r e sid e ntial s e tting, the faoility shall
assure that the patient has boon provid e d with a discharge
plan that incorpo r ate s tho utilization of oommunity r esources
when available and when included in tho pationt's plan of
( e ) — Th e int e nsity of phyoioian m e dioal aorviooo and th e
frequency of regular contacts for medical care for tho
pationt shall bo determined by tho pationt's pathophysiologic
— (£) — Whor e th e attending physician of a pati e nt in an
inpatient — r ehabilitation — facility — or unit orders medical
consultations for tho pationt, such consultations shall bo
provid e d by qualifi e d phyoioiano within 4 8 hours of th e
phyoioian'o ord e r. — In ord e r to aohi e v e this result, th e
contracts or agreements botwoon inpatient rehabilitation
facilities or units and medical consultants shall require that
such consultants render th e requested medioal consultation
within 4 8 hours.
(g) An inpatient rehabilitation facility or unit shall have
a — written procedure for sotting tho qualifications of tho
physicians rendering physioal rehabilitation oerviooo in th e
faoility or unit.
Statutory Authority G.S. 13 IE- 104.
. 1 1 52 ADMISSION CRITERIA FOR INPATIENT
REHABILITATION FACILITIES OR UNITS
(a) Tho facility shall have written criteria for admission
to th e inpati e nt rehabilitation facility or unit. — A descript i on
of programs or sorvioes for sorooning the suitability of a
givon pationt for placement shall bo available to staff and
referral sources.
(b) — For pati e nts found unsuitable for admission to th e
inpatient rehabilitation — faoility or unit, there shall b e
documentation of tho reasons.
— fe) — Within 48 hours of admission a preliminary assess
m e nt shall b e oomplotod by m e mb e rs of th e interdisciplinary
t e am to insur e th e appropriateness of plac e m e nt and to
identify the immediate needs of tho patient.
(d) Patients admitted to an inpatient rehabilitation faoility
or unit must b e abl e to tol e rate a minimum of thr ee hours of
r e habilitation th e rapy, fiv e days a w ee k, inoluding at l e ast
two of tho following rehabilitation services ; physioal
thorapy, occupational thorapy or speech therapy.
( e ) Patients admitted to an inpatient rehabilitation faoility
♦
79
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
of unit must bo medically stable, have a prognosis indicating
a progressively improv e d modioal condition and hav e th e
potential for increased indep e nd e nc e .
Statutory Authority G.S. 13 IE- 104.
.1153 COMPREHENSIVE INPATIENT
REHABILITATION EVALUATION
(a) A comprehensive, inpatient rehabilitation evaluation Statutory Authority G.S. 13 IE- 104.
i e r e quired for e aoh pati e nt admitted to an inpatient rehab i li
needs of the patient and shall partic i pate in all team confe r ■
onoos oonoeming th e pati e nt' s progress toward th e aooom
pliohment of specifi e d goals. — Any of th e prof e ss i onal staff
involved in the patient's care may bo the designated case
manager for one or more cases, or the director of nur s ing
or oooial work e r may acc e pt the coordination r e sponsibil i ty
for th e pati e nts.
tation facility or unit. — At a minimum this e valuation shall
include the reason for referral, a s ummary of the patient's
clinical condition, functional strengths and limitations, and
.1155 DISCHARGE CRITERIA FOR INPATIENT
REHABILITATION FACILITIES OR
UNITS
indications for op e oifio s e rvic e s. — This e valuation shall b e (a) — Discharg e planning shall b e an int e gral part of the
oompl e t e d within throe days,
(b) Each patient shall bo evaluated by the interdisciplinary
pati e nt's tr e atm e nt plan and shall b e gin upon admission to
tho facility. — After established goals have boon reached, or
team to determine the need for any of the following sor a determination has boon made that care in a los s intensive
vio e o: — m e dical, — dietary, — occupational therapy, physical
therapy, prosthetics and orthotics, psyohologioal assessment
s e tting would b e appropriat e , or that furth e r progr e ss is
unlik e ly, th e pati e nt shall b e discharged to an appropriate
and therapy, therapeutic recreation, rehabilitation medicine, s otting. Other reasons for discharge may include an
rehabilitation nursing, therapeutic counseling or social work,
vocational r e habilitation e valuation and speech languag e
pathology.
Statutory Authority G.S. 131E-104.
.1154 COMPREHENSIVE INPATIENT
REHABILITATION INTERDISCIPLINARY
TREAT/PLAN (c) — If a patient i s being referred to another facility for
(a) Th e int e rdisciplinary tr e atm e nt t e am shall develop an further oar e , appropriat e documentation of th e pati e nt's
individual treatment plan for eaoh pati e nt within s e v e n days ourr e nt status shall bo forward e d with th e pati e nt. — A formal
inability or unwillingness of patient or family to cooperate
with th e plann e d th e rapeutio program or m e dioal oomplioa
tiono that pr e clud e a further intensiv e r e habilitativ e e ffort.
Tho facility shall involve tho patient, family, staff members
and referral sources in discharge planning ^
—(b) — Th e ease manager shall facilitat e th e discharge or
transf e r proo e so in coordination with th e facility oooial
workers.
after admission. Tho plan shall include evaluation findings
and information about tho following;
(t) prior level of function;
ourr e nt functional limitations;
s pecific service needs;
-(4) treatment, supports and adaptations to be pro
vid e d;
-(5) sp e cifi e d treatment goals;
di s charge summary shall bo forwarded within 48 hours
following discharge and shall include tho reason s for
referral, — the — diagnosi s; — functional — limitation s; — s e rvic e s
provid e d, th e results of servic e s, r e f e rral aotion rooomm e n
dations and activities and procedures used by tho patient to
maintain and improve functioning.
Statutory Authority G.S. 131E-104.
.1156 COMPREHENSIVE REHABDLITATION
PERSONNEL ADMINISTRATION
(6) disciplines respon s ible for implementation of
separate parts of tho plan; and
(?) anticipat e d tim e frames for th e aooomplishm eat-
of sp e cified long t e rm and short term goals. (a) — The facility shall hav e qualified staff memb e r s ,
(b) Tho treatment plan s hall bo reviewed by tho intordi s ci consultants and contract personnel to provide son 1 iocs to tho
plinary team at least every other week. — All members of tho patients admitted to tho inpatient rehabilitation facility or
interdisciplinary team, or a repres e ntativ e of their discipline, unit-
shall att e nd e aoh meeting. — Docum e ntation of e aoh r e vi e w (b) Personn e l shall b e e mploy e d or provid e d by oontrao
tual agree men t in sufficient typos and number s to moot tho
needs of all patients admitted for comprehen s ive rohabilita
(o) Written agre e m e nts shall b e maintain e d by th e facility
when services are provided by contract on an ongoing basis.
shall include progress toward defined goals and identifier
tion of any changes in tho treatment plan-
Co) Th e treatm e nt plan shall inolud e provisions for all of
th e o e rvioos identifi e d as needed for tho patient in tho
comprehensive inpatient, rehabilitation evaluation completed
in accordance with Rule .1153 of this Subchapter.
—(d) — Eaoh pati e nt shall have a designat e d oaso managor Statutory Authority G.S. 131E-104.
who is r e sponsibl e for the coordination of th e pati e nt's
individualized treatment plan. — Tho oaso manager is rospon
siblo for promoting tho program's responsiveness to tho
.1157 COMPREHENSIVE INPATIENT
REHABILITATION PROGRAM STAFFING
10:2
NORTH CAROLINA REGISTER
April 17, 1995
SO
PROPOSED RULES
REQS
(a) Th e staff of tho inpati e nt r e habilitation fooility or unit
ohall includ e at a minimum:
(+) Tho inpatient rehabilitation facility or unit shall
bo supervised by a rehabilitation nuroo. — The
facility ohall identify th e nuroing okil l s n e c e ssary
to moot tho needs of the rehabilitation pati e nts in
tho unit and assign staff qualified to moot those
needs.
(3) Th e minimum nursing hours p e r pati e nt in th e
r e habilitation unit ohall b e 5.5 nursing hours p e r
patient day. At no time shall direct oaro nur s ing
staff bo loos than two full time equiva l ents, one
of whioh shall b e a r e gistered nurs e ;
(3) Th e inpati e nt rehabilitation unit shall e mploy o r
provide by contractual agreements sufficient
therapists, lioonsod in North Carolina, to provide
a minimum of thr ee hours of sp e cific (physical,
occupational or spoooh) or oombin e d r e habilita
tion therapy services por patient day.
(4) Physical — therapy assistants and occupational
thoropy assistants shall b e lio e no e d or c e rtifi e d
and shall be oup e rvio e d on site by lioonsod
phy s ical — therapists — o r lioonsod — occupational
therapists.
(5) R e habilitation — aid e s — shall — hav e — docum e nted
training appropriate to tho ootiviti e s to be per
formed and tho occupational licensure laws of
his or hor suporvisor. Tho ovorall responsibility
for th e on going sup e rvision and e valuation of
th e r e habilitation aid e r e mains with th e r e gis
torod nurse as identified in Subparagraph (a)(1)
of this Rule. — Supervision by tho lioonsod physi
oal therapist or by the occupational therapist is
limited to that tim e wh e n th e th e rapist is on site
and directing tho rehabilitation activ i ties of tho
(6) Hours of sorvio e by the rehabilitation aide are
count e d toward th e required nuroing hours wh e n
tho aide is working under tho supervision of tho
lioonsod nur s e. Hours of service by tho rehabili
tation aid e ar e oount e d toward th e rapy hours
during that tim e th e aide works und e r th e imm e-
diate, on sito supervision of tho lioonsod physical
th e rapist or occupational therapist. — Hours of
s e rvic e shall not b e dually oount e d for both
s e rvio e s. — Hours of sorvio e by r e habilitation
aides in performing nurse aide duties in areas of
tho facility other than tho rehabilitation unit shall
not b e oount e d toward tho 5.5 hour minimum
nursing requir e m e nts described for tho rohabili
tation unit.
(b) Additional personnel shall bo provided as required to
moot tho needs of tho pati e nt, as d e fin e d in th e comprehen -
siv e , inpati e nt rehabilitation e valuation.
Statutory Authority G.S. 13 IE- 104.
. 1 158 STAFF TRAINING FOR INPATIENT
REHABILITATION FACILITIES OR UNIT
— Prior to th e provision of oar e , all r e habilitation p e rsonn e l,
excluding physicians, assigned to tho rehabilitation unit shall
bo provided training or shall provide documentation of
training that inoludoo at a minimum th e following:
— (±) act i v e and passiv e rang e of motion;
— (3) assistance with ambulation;
— (3) transfers;
— (4) maximizing functional ind e p e nd e nce:
— (5) th e poyoho social — needs — of the — r e habilitation
patient;
—(6) tho increased safety risks of rehabilitation trainin g
(including falls and the use of restraints);
— (?} prop e r body moohanios;
— (8) nutrition, — including dysphagia and rostorativo
eating;
— (9) communication with th e aphaoio — and hearing
impair e d pati e nt;
(10) behavior modification;
(11) bowel and bladder training; and
(12) skin oar e-
Statutory Authority G.S. 131E-104.
.1159 EQUIPMENT REQS/COMPREHENSIVE
INPATIENT REHABILITATION PROGRAMS
—(a) — Tho facility shall provide each discipline with tho
necessary equipment and treatment methods to achieve tho
short and long term goals sp e cifi e d in th e compr e h e nsiv e
inpati e nt rehabilitation int e rdisciplinary treatm e nt plans for
patients admitted to those facilities or units.
(b) — Each patient' s need s fo r a standard wheelchair or a
sp e cially d e sign e d wheelchair or additional d e vio e s to allow
oaf e and ind e p e nd e nt mobility within th e facility shall be
—(e) — Special physical thorapy and occupational therapy
e quipm e nt for use in fabricating positioning do vices for bode
and wheelchairs ohall b e provid e d, inoluding splints, oasts,
cushions, wedges and bolster s .
(d) Physical thorapy devices shall bo provided, including
a mat table, parallel bars and sliding boards and s p e cial
adaptiv e bathroom e quipment.
Statutory Authority G.S. 13 IE- 104.
.1160 PHYSICAL FACILITY REQS/INPATIENT
REHABILITATION FACILITIES OR UNITS
(a) Tho inpatient rehabilitation facility or unit shall bo in
a designated area and ohall b e us e d for th e opocifio purpose
of providing a compr e h e nsiv e , — inpatient — rehabilitation
program.
(b) Tho floor area of a single bedroom shall be sufficient
for the pati e nt or th e staff to e asily transf e r th e pati e nt from
th e b e d to a wboolohair and to man e uv e r a 1 8 d e gr ee turn
with a wheelchair on at least one side of tho bod.
(c) — The floor area of a multi bod bedroom shall be
suffici e nt for th e pati e nt or th e staff to e asily transf e r th e
I
Si
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
patient from the bod to a wheelchair and to maneuver a
1 8 d e groo turn with a wheelchair b e tw ee n b e ds.
(d) — Eaoh patient room chall moot th e following r e quir e
mont s !
— m-
include!
— w-
offio e opao e for otnff;
-&h
Maximum room capacity of no more than four
pati e nts;
Oporablo windows;
-(3) offio e spao e for spoooh therapy e valuation and
treatment;
waiting space;
training bathroom whioh inolud e o toil e t, lavatory
(3} A nuroo call system dooignod to moot the special
needs of rehabilitation patients;
(4) In single and two bod rooms with private toilet
room, the lavatory may b e looatod in th e toil e t
room;
(5) A wardrobe or closet for each patient which is
whoolohair aooessibl e and arranged to allow th e
patient to aoo e ss the contents;
(6) A chest of drawers or built in drawer s torage
with mirror above, which is wheelchair acoossi
bl e ; and
(7) A bedside table for toil e t artiol e s and p e rsonal
— (o) Space fo r emergency oqu i pmont such as resuscitation
oarts shall be provid e d and shall b e under direct control of
th e nursing staff, in proximity to th e nur se ' s s tation and out
of traffic.
and bathtub;
-(#) gymnasium or exorcise area;
-(&-
work area such as tables or counters suitable for
■W-
wh ee lchair aoo e so;
tr e atm e nt areas with available privacy ourtaino
or s creen s ;
( 8 ) an activities of daily living training kitchen with
sink, cooking top (s c our e d wh e n not sup e rvised
by staff), refrigerator and counter surface for
moa l — preparation;
— (9) s torage for clean linens, supplie s and oquipmont;
(10) janitor's olos e t aooossiblo to the th e rapy ar e a
with floor r e o e ptor or s e rvic e sink and storag e
space for housekeeping supplies and oquipmont,
one closet or s pace may servo more than one
area of th e inpatient rehabilitation facility or
unit; and
(11) hand washing facilities.
-(f) — Pationts' bathing facilities s hall moot the following — (+) — For social work and psychological services the
sp e oifioationo:
ft) Th e r e shall bo at least on e shower stall or on e
bathtub for each 15 bods not individually served.
Each tub or shower shall be in an individual
room or privacy e nclosure whioh provid e s spac e
for th e private u se of the bathing fixtur e , for
drying and dressing and for a wheelchair and an
assisting attendant.
(3) Showers in c e ntral bathing facilities shall b e at
l e ast fiv e foot squar e without ourbo and d e sign e d
to permit use by a wheelchair patient.
(3) At least one five foot by seven foot shower shall
b e provid e d whioh oan accommodat e a str e tch e r
and an assisting attendant.
(g) — Patients' toilet rooms and lavatories shall moot the
following specificat i ons:
(4) Th e size of toilets shall permit a wh ee lohair, a
s taff p e rson and appropriat e — wheel to water
closet transfers.
(3) A lavatory in the room s hall pormit whoolohair
following shall b e provid e d:
(4) offio e spao e for staff;
(3) office space for private interviewing and coun
soling for all family members; and
(5) workspao e for t e sting, evaluation and oounsel
iagr
(j) If prosthetics and orthotic s service s are provided, the
following space s hall bo made available as necessary!
(4) work spao e for t e chnician; and
(3) spao e for e valuation and fittings (with provisions
for privacy),
(k) — If vocational therapy s ervices are provided, the
following s pao e shall b e mad e availabl e as n e o e soory:
-(4} offio e spao e for staff;
-(3) workspace for vocational sorvioos activities s uch
as provocational and vocational evaluation;
-(£) training spaoo
storag e for e quipm e nt; and
■&h
ponru t-
aoo e ss.
Lavatori e s s e rving pati e nts shall:
{§) coun s eling and placement space.
(1) Recreational therapy spaoo requirements include the
following:
(4) activities spao e ;
-(A) — allow wheelchairs to extend under the lavatory;
(2) storage for oquipmont and supplies;
-(3) office space for staff; and
(B) — hav e water supply spout mount e d so that its
discharge point is a minimum of five inohos
above the rim of the fixture
(4) Lavatories used by pationts and by staff shall bo
e quipp e d with blad e operated supply valv e s,
(h) Th e spaoo provid e d for physical th e rapy, oooupational
therapy and spooch thorapy by all inpatient rehabilitation
facilities or units may bo shared but mu s t, at a minimum,
-(4>-
aoo e ss to mal e and f e mal e toilets.
(m) Th e following spao e shall b e provided for pati e nt's
dining, recreation and day areas:
(4) s ufficient room for whoolohair movemont and
whoolohair dining s e ating;
-m-
if food s e rvioe is cafeteria typ e , ad e quat e width
for wheelchair maneuvers, quouo spaoo within
tho dining area (and not in a corridor) and a
10:2
NORTH CAROLINA REGISTER
April 17, 1995
82
PROPOSED RULES
serving counter low enough to view food;
£i) total spaoo for inpationto, a minimum of 25
square foot per bod;
(4) for outpatients participating in a day program or
partial day program, 20 square foot when dining
io a part of the program and 10 square feet when
dining is not a part of the program; and
(5) storage for rocroational equipment and supplies,
tables and chairs.
—(b) — The pationt dining, roor e ation and day area spaooo
shall bo provided with windows that hav e glazing of an ar e a
not loss than eight percent of the floor area of the space, at
least one half of the required window area must bo operable,
(o) — A laundry shall b e availabl e and aoo e ssibl e — for
pati e nts.
Statutory Authority G.S. 13 IE- 104.
.1161 ADDITIONAL REQUIREMENTS FOR
TRAUMATIC BRAIN INJURY PATD2NTS
Inpatient rehabilitation facilitie s providing services to
poroono with traumatica brain injuries shall moot the requir e
meats in this Rule in addition to those identifi e d in this
Section.
— (4) Direct care — nursing — personnel — stuffing — ratios
establish e d in Rul e . 1 157 of this S e otion shall not
be appli e d to nursing s e rvio e s for traumatic brain
injury patients in the inpatient, — rehabilitation
facility or unit. — The minimum nursing hours per
traumatic brain injury pati e nt in th e unit shall b e
6.5 nursing hours p e r pationt day. — At no tim e
shall direct care nursing s taff bo loss than two
full time equivalents, one of which shall bo a
r e gist e r e d nurs e .
— (2) The inpatient r e habilitation faoility or unit shall
employ or provide by contractual agreements
physical, occupational or s peech therapists in
ord e r to provide a minimum of 1.5 hours of
specific or oombin e d r e habilitation therapy s e r
vices per traumatic brain injury pationt day.
— (3) The facility shall provide special faoility or equip
m e nt needs for pati e nts with traumatic brain
injury, inoluding a qui e t room for therapy, sp e
cially designed wheelchairs and standing tables.
— (4) The medical director of an inpatient traumatic
brain injury program shall hav e two years man
ag e m e nt in a brain injury program, on e of whioh
may bo in a clinical fellowship program and board
eligibility or certification in tho medical specialty
of th e physician's training.
— (5) Th e faoility shall provid e th e consulting oorvioeo
of a neuropsychologist.
— (6) The faci l ity shall provide continuing education in
th e oar e and treatm e nt of brain injury pati e nts for
all staff.
— (7) The size of tho brain injury program shall bo
adequate to support a oomprohonsivo, dodioatod
ongoing brain injury program.
Statutory Authority G.S. 131E-104.
. 1 162 ADDITIONAL REQUIREMENTS FOR
SPINAL CORD INJURY PATIENTS
Inpatient rehabilitation facilities providing services to
p e rsons with spinal cord injuries shall moot th e r e quir e m e nts
in this Rule in addition to thos e id e ntified in this Section .
— (4) Direct oare — nursing — personnel — staffing — ratios
established in Rule . 1 157 of thi s Section shall not
b e appli e d to nursing sorvioos for spinal oord
injury patients in th e inpati e nt) — rehabilitation
facility or unit. — Tho minimum nursing hours per
spinal oord injury pationt in tho unit shall be 6.0
nursing hours p e r pati e nt day. — At no tim e shall
dir e ct oar e nursing staff bo looo than two full tim e
equivalents, one of whioh shall be a registered
nurs e .
—(2) Th e inpati e nt r e habilitation faoility or unit shall
employ or provid e by contractual agr ee m e nts
physical, occupational or s peech therapi s ts in
order to provide a minimum of 4 .0 hours of
sp e oifio or oombin e d r e habilitation th e rapy s e r
vices per spinal oord injury pati e nt day.
—(3) The facility s hall provide special faoility or special
equipment needs of patients with spinal oord
injury, inoluding specially d e signed whoolohairo,
tilt tables and standing tabl e s.
— (4) Tho medical director of an inpatient spinal oord
injury program shall have either two years expori
e no e in th e m e dioal oar e of p e rsons with spinal
oord injuri e o or six month's minimum in a spinal
cord injury fellowship.
—(5) Tho facility shall provide continuing education in
th e oar e and tr e atm e nt of spinal oord injur)' pa
tionts for all staff.
— (6) Tho facility shall provide s pecific s taff training
and education in tho oare and treatment of spinal
oord injury.
— (7) The siz e of th e spinal oord injury program shall b e
adequate to support a oomprohonsivo, dedicated
ongoing s pinal oord injury program.
Statutory Authority G.S. 13 IE- 104.
. 1 163 DEEMED STATUS FOR INPATIENT
REHABILITATION FACILITIES OR UNITS
(a) — If an inpatient rehabilitation facility or unit with a
comprehensive inpatient rehabilitation program is surveyed
and accredited by tho Joint Commission for tho Aooredita
tion of H e alth Care Organizations (JCAHO) or th e Comm w-
sion on Accr e ditation of R e habilitation Facilities (CARF),
and has boon approved by tho Department in aooordano e-
with G.S. 13 IE, Article 9 , the department dooms tho faoility
to bo in oompliano e with Rul e s .1150 through .1160 and
. 1 163 of this Section.
(b) Doomed status shall be provided only if tho inpatient
rehabilitation faoility or unit providos oopios of survey
reports to th e Division. Th e JCAHO report shall show that
♦
83
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
the facility or unit was s urveyed for rehabilitation services.
Th e CARF r e port shall ohow that th e faoility or unit was
surv e y e d for oomprehenoiv e r e habilitation services. — %
facility or unit shall sign an agreement (Memorandum of
Understanding) specifying those terms.
(o) — Th e inpatient rehabilitation faoility or unit shall b e
subject to insp e ctions or oomplaint inv e stigations by ropre
sontativos of the Department at any time. — If the facility or
unit i s found not to bo in compliance with the rules listed in
Paragraph (a) of this Rule, the faoility shall submit a plan of
corr e ction and be subjoot to a follow up visit to assur e
compliance.
(d) If the inpatient rehabilitation facility or unit lose s or
does not ren e w its accr e ditation, th e facility or unit shall
notify' the Division in writing within 30 days. -
Statutory Authority G.S. 131E-104.
SECTION .1200 - ACTIVITIES AND
RECREATION
.1204 DESIGNATED PERSON
Th e faoility administrator shall d e signat e an activities and
recreation services director who shall bo under the ad mini s
trativo supervision of the administrator, bo responsible for
th e activiti e s and r e or e ation sorviooo for all pati e nts and who
shall hav e appropriate manag e m e nt authority. — Any dir e otor
hired on or after the effective amended date of this Rule
shall bo a qualified professional who!
— (4) Is a th e rap e utio r e oreation s p e cialist or th e rap e utic
r e or e ation assistant o e rtified by the North Carolina
State Board of Therapeutic Recreation Cortifica
tion pur s uant to G.S. 90C 9 or is oligiblo for
c e rtification as a thorapoutio r e or e ation specialist
by a rooogniz e d — aoor e diting body; or
— (2) Has two years of oxporionco in a social or rooro
ation program within the lost five years, one of
which was full tim e in a resident activiti e s pro
gram in a h e alth oare setting; or
— (?) Is a qualified occupational therapist or occupa
tional therapy assistant licensed a s ouch by the
North Carolina Board of Occupational Therapy
pursuant to G.S. 90 270.70; or
—(4) Is oertified by the National Certification Council
for Activity Professionals; or
(5) Has oomplotod an aotivities training oouro e ap
proved by th e State.
Authority G.S. 131E-104; 143B-1 65(10); 42 U.S.C. 1396;
42 C.F.R. 483.15(f).
.1206 ACTIVITY PROGRAM: GOALS AND SCOPE
(a) — Restoration to self oar e and r e sumption of normal
activity shall bo one of the main goals of the recreation or
activity' program,
(b) Th e soop e of th e aotivity program shall includ e :
(1) oooial aotiviti e s involving individual and group
participation which are designed to promote
group relationships;
(3) r e oreational aotiviti e s, both indoor and outdoor;
(?) opportunity to participat e in aotivities outside the
facility;
(4) assisting patients and residents exorcise thoir
right to attend church and religious programs of
th e ir ohoio e ;
(#) creative and expressive activities;
(6) educational activities; and
-O-
e x e rois e .
Statutory Authority G.S. 131E-104.
.1207 POLICIES AND PROCEDURES
Th e faoility shall have writton polioi e s and procedures
which ore available and implemented by staff that:
— (4) attempt to prevent the further mental or physical
d e terioration for thos e pati e nts or residents who
cannot r e alistically r e sume normal aotiviti e s;
— (3) assure opportunities for patient involvement, both
individual and group, in both planning and imple -
menting th e aotivity program;
— (?) provid e patients or residents th e opportunity for
choice among a variety of activities; and
— (4) encourage participation by each patient or resident
in social and recreational aotiviti e s according to
individual need and abiliti e s and dosires unless the
patient's or resident's record contains documenta
tion that ho is unable to participate.
Statutory Authority G.S. 131E-104.
.1208 DOCUMENTATION
(a) — Eaoh pati e nt's or r e sid e nt's aotivity plan shall b e a
part of his overall plan of oare and shall contain documenta
tion of periodic assessments of the individual's activity
needs and intere s ts. — A record of activities and individuals
participating shall bo maintain e d in th e faoility.
(b) — A licensed faoility shall display a monthly aotiviti e s
calendar which includes a variety to appeal to different
interest groups in all lovols of care for which the faoility is
licensed.
.1205 RESOURCES
The facility shall maintain and make available a listing of
looal resouro e o for aotiviti e s and reor e ation to bo utilized in
mooting the needs and inter e sts of all pati e nto and r e sidents.
Statutory Authority G.S. 13 IE- 104.
Statutory Authority G.S. 13 IE- 104.
.1210 SUPPLIES AND EQUIPMENT
There shall bo e quipment and suppli e s suffici e nt to oarry
out planned programs for both individual and group activi
10:2
NORTH CAROLINA REGISTER
April 17, 1995
84
PROPOSED RULES
Statutory Authority G.S. 13 IE- 104.
SECTION .1300 - SOCIAL SERVICES
.1306 DESIGNATED PERSON
Th e Adminiotrator ohall dooignat e an e mployee to bo
rooponoiblo for the provioion of oooial oorviooo who ohall b e
known as the Social Services Director, — Sub s equent to the
effective date of the rules contained in this Subchapter - any
newly designat e d p e roon must b e a graduat e of a four y e ar
coll e g e or univ e rsity with one y e ar'o e xp e ri e nc e in th e
health care or long term care field or have an equivalent
combination of education and experience. — An equivalent
combination of e ducation and experi e nc e m e ano th e numb e r
of years of e ducation l e ading to a baooalaureate or associat e
degree plus the number of years of long term nursing
facility experience equal to five years; or elig i ble for
c e rt i fication ac a social worker pursuant to G.S. 90B 7.
Th e Social S e rvices Dir e otor ohall hav e authority to oarry
out provisions contained in Rule .1307 of thi s Section.
Statutory Authority G.S. 131E-104.
. 1307 PLAN OF SERVICES
(a) Each patient's or resident's plan of care shall contain
a writt e n plan for mooting hio individual soc i al n ee ds and
involving hie activ e partic i pation.
(b) — The plan shall provide for needed assistance in
mooting the patient's or resident' s phys i cal, social and
e motional noodo through consultation with the patient or
r e sid e nt, l e gal guardian or hio r e lative, physician and/or
others.
— (e) — The plan shall provide for assisting the patient or
resident in adjusting to his e nvironm e nt, for r e ferral to other
supporting r e oouro e o, for protectiv e o e rvio e a, for financial
services and for assistance at the time of discharge or
transfer into a now environment.
(d) Th e plan shall provid e for th e utilization of cas e work
e re e mployed by the county Department of oooial s e rvices in
the case of recipients of public assistance and for the
utilization of appropriate persons with experience and
training in the gonoral area of oooial work in th e ease of
those not on publio aooiotano e .
Statutory Authority G.S. 131E-104.
.1308 DISCHARGE PLANNING
(a) — Discharge planning s hall be in keeping with each
patient's and re s ident' s post discharge needs.
(b) — Th e Adminiotrator ohall aoour e that a medical order
for diooharg e including any sp e cial inotruotiono for m e eting
rehabilitation potential i s obtained for all patients o r roei
dents except when a patient or resident loave s again s t a
phyoioian'o order or advio e .
(o) — Th e Social S e rvioeo Dirootor shall ooordinato die
charge inotructions and assure that patients and residents and
their familie s are instructed in accordance with discharge
orders.
Statutory Authority G.S. 13 IE- 104.
SECTION .1400 - SPECIAL REQUIREMENTS
.1405 EMERGENCY PROCEDURES
(a) Each e mploy ee providing d i r e ct patient oare ohall be
train e d in at l e ast th e following:
(4) use of emergency equipment such as oxygon and
suction apparatus*,
(3) proc e dur e to follow with ohoking viotimo; a nd
(3) proc e dure to follow in oummoning aooiotanoe
required for emergency r escue, law enforcement
or protection and fire.
(b) — P e rsonn e l fil e o for patient oare employooo must
contain — docum e ntation — te — r e fl e ct — that employooo — hav e
successfully completed training in the areas described in
Paragraph (a) of this Rule.
Statutory Authority G.S. 13 IE- 104.
.1406 REPORTABLE DISEASE
All oas e s of reportabl e dio e ao e as required by the Comm ie-
aion for H e alth S e rvio e o (10 NCAC 7A .0100) and e pidomio
outbreaks, and poisonings shall bo reported immediately to
the local Health Director and the Department.
Statutory Authority G.S. 13 IE- 104.
.1408 RESTRAINTS
— (a) — Patients and rooidento ohall bo restrained only oo
provid e d for in D e claration of Patients' Righto, G. S .
13 IE 117(6) and in accordance with policies implemented
pursuant to Rule .0505(f).
(b) In emergency s ituations e ith e r th e nurs e in charg e or
a r e gister e d nurs e in a high e r supervisory position, ohall b e
responsible for making the determination r elative to noeo s
sity for the typo and duration of phy s ical restraint to use
whil e contacting a physician.
(o) Th e typo of restraint used and the time of application
and removal ohall bo recorded by a licensed nurse in the
patient's or resident's record.
Statutory Authority G.S. 131E-104.
.1409 REPORT OF DEATH
A lioenood fdoility shall have a written plan to b e follow e d
wh e n a patient dies. The plan muot provid e for th e follow
—(4) collection of data needed for death certificate a s
r e quir e d by G.S. 130A 117;
— (3) record i ng tim e of d e ath;
-&r
-w
pronouncement of death by a phys i cian or medical
examiner;
notification of att e nding physician r e sponsibl e for
signing d e ath o e rtifieato if different from physician
pronouncing death;
■(§) notification of next of kin or legal guardian if one
has boon appointed;
♦
85
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
-(6) authorization arid release of body to funeral homo;
-&-
notification to th e D e partment of any death rooult
ing from on injury, accident or other possible
unnatural causes.
Statutory Authority G.S. 131E-104.
.1410 PETS (COMPANION ANIMALS)
(a) No animal ohall be brought into th e facility e xo e pt in
aooordanoe with Paragraph (b) of this Rul e .
(b) A patient's or resident's personal pot may bo brought
into the facility for a short visit under tho following condi
tions:
(4) th e facility's polio ie o and prooedur e o p e rmit p e t
visitation and tho policies are followed during
tho visit;
(2) boforo a dog or oat may e nt e r th e faoility, proof
of immunization against rabies ohall b e oubmit
t od to tho Administrator; and
(3) pots shall not bo permitted in areas whore food
or drink is pr e par e d or s e rv e d.
Statutory Authority G.S. 131E-104.
SECTION .1500 - DESIGN AND CONSTRUCTION
.1501 GENERAL RULES
(a) — Each facility must bo planned, constructed, and
e quipp e d to provid e th e s e rviooo offered to b e p e rformed in
th e faoility.
(b) Any existing building converted to a nursing homo or
related facility shall moot all requ i rements of a now facility.
(o) — The sanitation, wat e r s upply, sewag e disposal, and
di e tary faoiliti e o must oomply with th e rules of the Commio
sion fof Health Services.
—(d) — The domiciliary home portion of a combination
faoility must moot th e rules for a nursing faoility oontain e d
in S e ctions .1500, .1600, .1700 and .1 8 00 of this Subohap
tor, except when separated by a two hour fire resistive
construction. — In this ease, tho domiciliary home portion
must moot tho ruloo for domioiliary homes, 10 NCAC 42D,
and supporting ar e as must b e looated in tho same area of tho
facility as tho domiciliary homo portion.
Authority G.S. 13 IE- 104; 42 U.S.C. 1396.
.1502 SITE
Tho site of tho proposed facility must bo approved by tho
D e partment prior to oonotruotion and ohall:
— (i) bo aoooooiblo by publio road s and publio tranopor
tation;
(2) bo accessible to fire fighting services;
— (3) bo provid e d with an approv e d water supply,
sewages disposal syst e m, garbag e disposal syst e m
and trash disposal system;
— (4) moot all local ordinances and zoning laws; and
— (5) bo free from exposure to hazards and pollutants.
Statutory Authority G.S. 131E-104.
.1503 PLANS AND SPECOTCATIONS
— (a) — When oonotruotion or remodeling io plann e d, fina l
working drawings and op e oifioations muot b e submitted by
tho owner or his appointed roprooontativo to tho Department
for review and approval. — Schematic drawings and prolimi
nary working drawings shall be submitted by tho owner
prior to th e required submission of final working drawings.
Tho Department will forward copie s of each submittal to tho
Departm e nt of Insurance and Division of Health Services for
r e vi e w and approval. — Three oopi e s of th e plans ohall b e
provid e d at e aoh submitta l-
(b) Approval of final plan s and sp e cification shall expire
one year from tho date granted unless a contract for tho
oonstruotion has boon s i gn e d prior to th e e xpiration dat e .
—(e) — If on approval e xpires, a renewed approval shall b e
i s sued provided revised plans mooting all current rogula
tions, codes, and standard s are s ubmitted.
(d) Compl e ted oonotruotion muot conform to the minimum
standards e stablish e d in Sections .1500, .1600, .1700 and
. 1 8 00 of this Subchapter. — Prior to approval for licensure,
one sot of "as built working drawings" must bo furni s hed to
th e Department.
( e ) — Th e own e r or his designated agent shall notify th e
Department when actual construction starts and at points
when construction is 50 percent, 75 percent, and 90 percent
of completion and upon final compl e tion, so that p e riodio
and final insp e ctions oan b e performed.
—(I) — Tho owner or his designated agent shall submit for
approval by tho Department all alterations or remodeling
ohong es whioh aff e ot th e otruotural integrity of th e building,
functional op e ration, fir e saf e ty or whioh add b e ds or
facilities over those for which tho facility is licensed.
Statutory Authority G.S. 13 IE- 104.
SECTION .1600 - FUNCTIONAL
REQUKEMENTS
.1612 REQWRED SPACES
—(») — The floor area of a single bedroom shall not bo loss
than 100 square foot and tho floor area of a room for more
than 1 b e d shall not bo less than 8 square foot per bod.
Th e 8 squar e f ee t and 100 square foot r e quirements shall
bo exclusive of closets, toilet rooms, vestibules or ward
robes : — When a designated sing l e room exceeds 159 square
foot floor ar e a, it ohall remain a singl e b e droom and cannot
b e us e d as a multi bedroom at any futur e date.
(b) — Tho total space sot aside for dining, recreation and
other common uses shall not bo loss than 25 square foot per
b e d for a nursing faoility and 30 square foot per bod for a
domioiliary hom e . Physical therapy and occupational
therapy space shall not bo included in thi s total;
(1) In now nursing homos divorsional activity and
10:2
NORTH CAROLINA REGISTER
April 17, 1995
86
PROPOSED RULES
therapeutic rocroation areas shall bo provided
soparato from the main living and dining ar e as.
(3) Dining, rooroation and other common use ar e as
shall bo designed and equipped to provide acooo
sibility to both wheel chair and ambulatory
pati e nto.
(3} Rooroation and other oommon uo e aroao shall be
designed for independent and group activity use.
(4) Closets and other storage areas for equipment
and ouppli e o shall not b e Includ e d in the required
dining, rooroation and oommon uo e floor opao e
(£) Handicap accessible outdoor areas for individual
and group aotiviti e o shall bo provid e d.
— («} — A toil e t room ohall bo dirootly aoo e ooiblo from e aoh
patient room and from oaoh central bathing area without
going through the general corridor. — One toilet room may
sorvo two pati e nt rooms but not mor e than e ight b e ds. — The
lavatory may b e omitt e d from th e toil e t room if on e io
provided in each patient room. — One tub or shower shall bo
provided for each 15 bods not individually sorvod. — There
ohall b e at least on e bathtub aoooooibl e on throe s i des and
one shower providod for oaoh 60 b e do or fraotion ther e of,
(d) — For each nursing unit or fraction thereof on each
floor, the following shall bo provided ;
(+) a m e dication preparation area with oounter, sink
with four inch hand loo, modioation r e frig e rator,
oyo lovol medication storage, eabinet storage,
and double locked narcotic storage room, located
adjao e nt to the nursing station or under vioual
oontrol of th e nursing station;
(2) a clean utility room with counter, sink with
four inch handles, wall and under counter stor
sge,
(3} a soil e d utility room with oounter, sink with
four inch handles, wall and under oounter stor
ago, a flush rim clinical sink or water closet
with a d e vic e for cl e aning bedpans and a m e ans
for washing and sanitizing b e dpano and other
utensils;
(4) a nurses' toilet and locker space for coats,
purses, oto.;
(5) an audiovisual nuroo patient call syst e m arrang e d
to ensure that a patient's call in the facility is
noted at a staffed station;
(6) a soil e d lin e n storag e room ohall bo provided;
f?) a clean linen s torage room shall be provided.
(o) — Clean linen storage shall bo providod in a s eparate
room for bulk oupplieo. — Cl e an lin e n for nursing units may
b e stor e d in oloo e d carte or oabin e ts in the oloan utility room
or in a linen clo s et on the unit floor.
(f) A soiled linen room shall bo provided.
(g) Eaoh nursing unit ohall b e provid e d with at l e ast on e
janitor's olooot. — D ie tary and laundry oaoh must have a
janitor's closet. Administration, occupational and physical
therapy, recreation, personal oaro, and employee facilities
shall bo providod janitor's olooeto and may shar e on e as a
group.
(h) Str e toh e r and wheelchair storage ohall bo providod.
— (i) — Bulk storag e shall b e provided at th e rate of five
square foot of floor area per bed.
(j) Office space must bo providod for persons holding the
following positions: Administrator, Dir e ctor of Nursing,
Social Servio e s Director. Activities and R e creation Dir e ctor,
and Physical Therapi s t, if offered. — There must also be a
business office.
Authority G.S. 131E-104; 42 U.S.C. 1396.
.1613 FURNISHINGS
(a) — Handgrips shall bo providod for all toil e t and bath
faciliti e s used by patiento. — Handrails shall bo providod on
both side s of all corridors used by patients.
(b) — For each nursing unit or fraotion thereof on each
floor, th e following ohall b e provid e d:
(4-) a nourishment station with work space, cabinet,
and refrigerated storage, a small stove or hot
plate in an area physically separated from the
nurses' station;
(3) one nurses' station consisting of d e sk opao e for
writing, storage space for office supplie s and
storage space for patients' records.
— (e) — Flam e proof privacy scr ee ns or ourtaino ohall b e
provid e d in multi b e dd e d rooms.
Statutory Authority G.S. 131E-104.
SECTION .1700 - FIRE AND SAFETY
REQUIREMENTS
.1703 NEW FACILrTY REQUIREMENTS
A now facility ohall moot tho requir e m e nts of th e curr e nt
North Carolina State Building Code and the following
additional r equirements:
— (4-) Eaoh floor uo e d for s l ee ping patients shall b e
divid e d into at least two sections by a smok e
barrier.
— (3) Whore nursing units are located on tho same floor
with oth e r D e partm e nts or servio e s, th e faoility
ohall b e d e sign e d to provide separation from th e
other Departments or s ervices with a smoke
barrier.
— (3) Horizontal e xits ar e not p e rmitted in any now
faoility.
Statutory Authority G.S. 131E-104.
.1704 ADDITIONS
An addition to an existing facility shall meet tho same
requirements as a now facility except that in no case shall
mor e than one horizontal e xit b e uo e d to r e plac e a r e quir e d
e xit to th e outsid e .
Statutory Authority G.S. 13 IE- 104.
87
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
SECTION .1800
MECHANICAL: ELECTRICAL:
PLUMBING
.1804 HEATING AND AIR CONDITIONING
Heating and cooling systems shall moot the current
Amerioan — Sooi e ty — of Heating, — R e frig e ration, — and Air
Conditioning Engin ee rs Guide and National Fire Prot e ction
Association Code 90 A (1 9 73 edition) with the following
modifications!
— fl-) Soiled lin e n, bathroomo, janitor olos e te and soil e d
utility rooms must hav e negative pr e ssur e with
relationship to adjacent areas.
— (3) Clean linen, clean utility and drug rooms must
hav e positive prooour e with relationship to adjac e nt
— (3) All areas not covered in (1) and (2) of this Rule
must have neutral pressure.
Statutory Authority G.S. 13 IE- 104.
.1805 EMERGENCY ELECTRICAL SERVICE
Em e rg e noy e l e otrioal oorvio e s hall b e provided for use in
th e e v e nt of failur e of th e normal e l e ctrical service. — This
omorgoncy service shall be made up as follows:
— (+) In any oxisting facility, the following must bo
provid e d:
(a) typ e 1 or 2 e m e rg e noy lights as r e quir e d by th e
North Carolina State Building Code;
(b) additional — omorgoncy — lights for all nursing
stations, drug preparation and storag e ar e as, and
for the telephone switohboord, if applicabl e ;
(e) one or more portable battery powered lamp s at
each nursing station; and
(d) a — suitable — sewee — of e m e rg e noy — pow e r for
lif e sustaining e quipm e nt, if th e home admits or
cares for occupants needing suoh equipment, to
e nsure continuous operation for a minimum of
72 hours.
— (3) Any addition to an e xisting faoility shall m e et the
same requirements as now construction.
— (3) Any conversion of an oxisting building (hotel,
mot e l, abandon e d hospital, abandon e d school,
e tc) shall moot the sam e r e quirements for emor
goncy electrical — sorvicos as required for now
construction.
— (4} For now construction, an e mergenoy generating
set, inoluding th e prim e mov e r and g e n e rator,
shall bo located on the promises and shall bo
reserved exclusively for s upplying the omorgoncy
e l e otrioal system.
— ($) Lighting for emerg e noy e l e otrioal servio e s shall b e
provided in the following place s :
(a) oxit ways and all nece s sary ways of approach
th e r e to, inoluding exit signs and e xit dir e ction
signs, e xterior of e xits, e xit doorway s , stair
ways, and corridors;
(b) dining and recreation room st
— (e) nursing station and modioation preparation area;
— (d} g e n e rator sot location, switoh g e ar location, and
boil e r room (if applicable); and
— (e) elevator (if required for emergency).
-(6) Emergency equipment which is essential to life,
saf e ty, and th e prot e ction of important e quipm e nt
or vital mat e rials shall b e provid e d:
nurses' calling system;
-(a)-
■<&■
-fe)-
-m-
-e-
alarm system including fire alarm actuated at
manual station s , wat e r flow alarm d e vio e s of
sprinkl e r syst e ms if e l e otrioally operated, fir e
detecting and smoke detecting s ystems, paging
or speaker systems if intended for issuing in
struotions during e m e rg e noy — conditions, and
alarms r e quir e d for nonflammabl e medical gas
systems, if installed;
fire pump, if installed;
-(e)-
-(d} sew e rag e or sump lift pump, if installed;
-(e)-
on e e l e vator, — wher e — elevators — ar e us e d for
vortical transportation of patients;
equipment suoh as burners and pumps necessary
for op e ration of on e or mor e boilers and thoir
n e c e ssary auxiliari e s and controls, required for
heating and sterilization, if installed;
equipment necessary for maintaining telephone
sorvioe;
A minimum of on e d e dioat e d e m e rg e noy branch
circuit per bod i s required for ventilator depend
ont patients in addition to the normal sys tem
r e o e ptaol e at e ach bed locat i on roquir e d by th e
National — El e otrioal — Cod e . This e m e rg e noy
circuit shall bo provided with a minimum of twe
duplex receptacles identified for omorgoncy use-
Additional e m e rg e noy branch oirouits/reooptaoles
shall b e provid e d wh e r e th e e l e otrioal lif e sup
port needs of the patient exceed the minim wn
requirements stated in this Subparagraph. — Eaeh
e m e rg e noy circuit serving ventilator d e p e nd e nt
pati e nts shall b e f e d from th e automatically
transferred critical branch of the essential olootri
col system. — This Subparagraph shall apply to
both n e w and e xisting facilities;
H e ating — e quipment — provid e d — fe* — v e ntilator
dependent patient bedrooms shall bo connec ted-
to the critical branch of the essential electrical
system and arranged for d e lay e d automatic or
manual conn e ction to th e e m e rg e noy pow e r
source if the heating equipment depends upon
electricity for proper operation. — This Subpara
graph shall apply to both n e w and e xisting
faciliti e s; and
Task lighting connected to the automatically
-o-
tmnsforrod critical branch of the essential oloctri
oal system shall be provided for e aoh v e ntilator
d e p e nd e nt pati e nt b e droom. — This Subparagraph
shall apply to both now and oxisting facilities.
Whore electricity is the only source of power
10:2
NORTH CAROLINA REGISTER
April 17, 1995
88
PROPOSED RULES
normally used for space heating, the emergency
sorvio e shall provid e for heating of patient roomo. -
Em e rg e noy h e ating of pati e nt rooms will not b e
required in areas whore th e nursing homo is
supplied — by — at — least — twe — separate — generating
souro e o, or a network distribution system with th e
nursing homo foodoro so routed, oonneot e d, and
protected that a fault any place between the gonor
ators and tho nursing homo will not likely cause
an int e rruption.
— (&) The e m e rg e noy — ele otrioal — system shall be so
controlled that after interruption of tho normal
electric power supply, tho generator is brought to
full voltag e and fr e qu e ncy and oonn e ot e d within
10 sooonds through one or mor e primary auto
matic transfer sw i tches to all emergency lighting,
alarms, nurses' call, equipment necessary — fer
maintaining t e l e phone sorvio e , and r e o e ptaol e s in
patient oorridors. — All other lighting and e quip
mont required to bo connected to tho emergency
system shall oithor be connected through tho 10
second primary automatic transfer owitohing or
shall bo subs e quently oonn e oted through other
automatic or manual tran s fer s witching. — Rooopta
clos connected to the emergency system shall bo
distinctiv e ly marked for identification.
— (9) Batt e ry pow e r e d corridor lights shall not r e plac e
tho requ i rements for tho emergency circuit nor bo
construed to substitute for tho generator — setr
Suffici e nt fu e l shall be stored for th e operation of
th e e m e rg e noy g e n e rator for a p e riod not leoo than
72 hours, on a 24 hour per day operational basis.
Tho systems shall bo test run for a period of not
l e oo than — 15 minut e o on a w ee kly sch e dul e .
R e cords of running tim e shall be maintained and
kept available for reference.
(10) To onsuro proper evaluation of dooign of omor
g e noy pow e r syst e ms, th e own e r or op e rator shall
submit with final working drawing s and s p e oifioa
tions a letter describing tho policy for admissions
and dischargee to bo used when tho facility begins
op e ration. — If subs e qu e nt y e arly insp e ctions for
lic e nsur e indicate th e admiooion polioi e o have boon
changed, tho facility will bo required to take
immediate stops to moot appropriate code require
m e nto for continued licensure.
Statutory Authority G.S. 13 IE- 104.
.1806 GENERAL ELECTRICAL
(a) All main water oupply shut off valves in th e sprinkl e r
3ystom must bo electronically supervised so that if any valve
is clo s ed an alarm will sound at a continuously manned -
c e ntral station.
(b) No two adjac e nt e m e rg e noy lighting fixtures shall bo
on tho same circuit.
(c) — Receptacles in bathrooms must have ground fault
prot e ction.
— (d) — Each patient bod location must bo provided with a
minimum of four singl e or two duplex reo e ptaol e s.
( e ) Eaoh pati e nt b e d location must b e ouppli e d by at least
two branch oircuito.
(f) Tho fire alarm system must be installed to transmit an
alarm automatically to th e fir e D e partment that is legally
committed to s e rv e th e area in whioh the facility io looat e d,
by tho most direct and reliable method approved by local
ordinances.
(g) In pati e nt ar e as, fir e alarms shall b e gongo or ohimoo
rather than horns or b e lls.
(h) All receptacles in patient uso areas must bo grounded
by an in s ulated oonduotor sized in accordance with Table
950 95 of tho 1975 National Elootrio Cod e .
Statutory Authority G.S. 131E-104.
.1807 OTHER
(a) In g e n e ral pati e nt ar e as, eaoh room shall bo sorvod by
at least one calling station and each bod shall be provided
with a call button. Two call buttons serving adjacent bods
may b e s e rv e d by on e oalling station. — Calls shall r e gister
with the floor staff and shall activat e a visibl e signal in th e
corridor — at — the — patient' s — er — resident's — door. la
multi corridor nursing unite, additional visible signals shall
b e install e d at corridor inters e ct i ons. — In rooms containing
two or mor e oalling stations, indicating lights shall b e
provided at each station. — Nurses' oalling sy s tems w hich
provide two way voice communication shall bo equipped
with an indicating light at e aoh oalling station whioh lighto
and r e mains lighted ao long as th e voio e oirouit io op e rating.
A nurses' call emergency button shall bo provided for
patients' and residents' uso at each patient and resident
toil e t, bath, and show e r room.
(b) At least one telephone ohall be availabl e in e aoh ar e a
to which patients are admitted and additional telephone s or
extensions as are necessary to onsuro availability in case of
(o) G e n e ral outdoor lighting ohall b e provid e d ad e quate to
illuminate walkways and drive.
(d) A flow of hot water within safety ranges specified ao
follows:
Patient Areas 6 ' /4 gallons per hour per bod and at
a temperature of 100 — 116 degree s F; and
Di e tary S e rvic e s 4 gallons p e r hour p e r bod and at a
t e mp e rature of 130 degrees — HO d e grooo F; and
Laundry Areas 4 'A gallons per hour per bod and at
a temperature of 130 dogroo s — 140 degrooo F.
( e ) Plumbing syst e ms ohall moot th e r e quir e m e nts of th e
North Carolina State Plumbing Code.
(f) The Administrator shall assure that isolation facilities
as approved by tho Departm e nt ohall b e available and uood
for any pati e nt admitt e d or r e tain e d with a communicabl e
disease.
Statutory Authority G.S. 13 IE- 104.
89
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
>
SECTION .2000 - GENERAL INFORMATION
.2001 DEFINITIONS
The following definitions will app ly throughout this
Subchapter:
(1) "Abuse" means the willful infliction of injury,
unreasonable confinement, intimidation or punish-
ment with resulting physical harm, pain or mental
anguish.
(2) "Accident" means an unplanned or unwanted event
resulting in die injury or wounding, no matter how
slight, of a patient or other individual.
"Accredited medical record technician" means a
m
£4}
£51
>
£61
m
>
£8}
£91
(10)
an
person trained in record maintenance and preser-
vation, and accredited by the American Medical
Record Association.
"Adequate" means, when a pplied to various
services, that the services are at least satisfactory
in meeting a referred to need when measured
against contemporary professional standards of
practice.
"Administrator" means a person licensed by the
North Carolina State Board of Examiners for
Nursing Home Administrators in accordance with
G.S. 90-276. Article 20. and who has authority
for and is responsible for the overall operation of
a facility.
"A ppropriate" means right, suitable or proper for
the specified use or purpose, suitable or proper,
when used as an adjective. When used as a
transitive verb it means to set aside for some
specified exclusive use,
"Brain injury long term care" means an interdisci-
plinary, intensive maintenance program for pa-
tients who have incurred brain damage caused by
external physical trauma and who have completed
a primary course of rehabilitative treatment and
have reached a point of no gain or progress for
more than three consecutive months. Services are
provided through a medically supervised interdis-
ciplinary process and are directed toward main-
taining the individual at the optimal level of
physical, cognitive and behavioral functions.
"Capacity" means the maximum number of patient
or resident beds for which the facility is licensed
to maintain at any given time.
"Case manager" means the individual responsible
for the coordination of services, for a given
patient, between disciplines so that the patient may
reach optimal rehabilitation through the judicious
use of resources.
"Combination facility" means a combination home
as defined in G.S. 131E-101.
"Comprehensive, inpatient rehabilitation program"
means a program for the treatment of persons with
functional limitations or chronic disabling condi-
(12)
(13)
(14)
(15)
(16)
(17)
£al
££l
£il
(18)
tions who have the potential to achieve a signifi-
cant improvement in activities of daily living. A
comprehensive, rehabilitation program utilizes a
coordinated and integrated, interdisciplinary
a pproach, directed by a physician, to assess
patient needs and to provide treatment and evalua-
tion of physical, psychosocial and cognitive
deficits.
"Convalescent care" means care given for the
purpose of assisting the patient or resident to
regain health or strength.
"Department" means the North Carolina Depart-
ment of Human Resources.
"Dietitian" means a person who meets the stan-
dards and qualifications established by the Com-
mission on Dietetic Registration of the American
Dietetic Association included in "Standards of
Practice" which is incorporated by reference.
including subsequent amendments. Copies of the
standards may be purchased for seven dollars and
twenty five cents ($7.25) or "Code of Ethics for
the Profession of Dietetics" for two dollars and
fifteen cents ($2.15). from the American Dietetic
Association. 216 W. Jackson Blvd.. Chicago. IL
60606-6995.
"Director of nursing" means a registered nurse
who has authority and direct responsibility for all
nursing services and nursing care.
"Discharge" means a patient who physically
relocates to another health care setting or is
discharged home or relocated from a nursing bed
to a domiciliary bed or from a domiciliary bed to
a nursing bed.
"Drug" means substances:
recognized in the official United States Pharma-
copoeia, official National Formulary, or any
supplement to any of them:
intended for use in the diagnosis, cure, mitiga-
tion, treatment, or prevention of disease in man
or other animals:
intended to affect the structure or any function
of the body of man or other animals, i.e..
substances other than food; and
intended for use as a component of any article
specified in Subitems (a), (b), or £cl of this
Subparagraph.
"Existing facility" means a facility currently
(19)
licensed or a proposed facility, proposed addition
to a licensed facility or proposed remodeled
licensed facility that will be built according to
plans and specifications which have been a pproved
by the Department through the design development
drawings stage prior to the effective date of this
Rule.
"Exit conference" means the conference held at
the end of a survey or investigation between the
Department's representatives and the facility
10:2
NORTH CAROLINA REGISTER
April 17, 1995
90
PROPOSED RULES
administration representative.
(20) "Facility" means a nursing facility or combination
facility as defined in this Rule.
(21) "Finding" (when used in conjunction with the
Nurse Aide program) means a determination by
the Department that an allegation of patient abuse (35)
or neglect, or misappropriation of patient property
has been substantiated.
(22) "HIV Unit" means designated areas dedicated to
patients or residents known to have Human Immu-
nodeficiency Virus disease.
(23) "Incident" means an unplanned or unwanted event
which has not caused a wound or injury to any
individual but which has the potential for such
should the event be repeated.
(24) "Inpatient rehabilitation facility or unit" means a (36)
free-standing facility or a unit (unit pertains to
contiguous dedicated beds and spaces) within an
existing licensed health service facility a pproved in
accordance with G.S. 131E, Article 9 to establish
inpatient, rehabilitation beds and to provide a
comprehensive, inpatient rehabilitation program.
(25) "Interdisciplinary" means an integrated process
involving a representative from appropriate disci- (37)
plines of the health care team.
(26) "Licensed" means holding a current and valid (38)
license as required under the General Statutes of
North Carolina.
(27) "Licensed practical nurse" means a nurse who is
licensed as a practical nurse under G.S. 90, (39)
Article 9A.
(28) "Licensee" means the person, firm, partnership,
association, corporation or organization to whom
a license has been issued. The licensee is the (40)
legal entity which is responsible for the operation
of the business.
(29) "Medical consultations" means consultations which
the rehabilitation physician, the attending physi- (41)
cian or other authorized persons determine are
necessary to meet the acute medical needs of the
patient and do not include routine medical needs. (42)
(30) "Medication" means drug as defined in Item (17)
of this Rule. (43)
(31) "Medication error rate" means a discrepancy
between what was ordered and what is actually
administered. It is the number of errors observed
divided by the o pportunities for error times 100. (44)
(32) "Misappropriation of property" means the deliber-
ate misplacement, exploitation, or wrongful, (45)
temporary or permanent use of a patient's belong-
ings or money without the patient's consent-
OS) "Neglect" means a failure to provide goods and (46)
services necessary to avoid physical harm, mental
anguish or mental illness.
(34) "New facility" means a proposed facility, a pro- (47)
(48)
posed addition to an existing facility or a proposed
remodeled portion of an existing facility that is
constructed according to plans and specifications
approved by the Department subsequent to the
effective date of this Rule. If determined by the
Department that more than half of an existing
facility is remodeled, the entire existing facility
shall be considered a new facility.
"Nurse Aide" means a person who is listed on the
N.C. Nurse Aide Registry and is in compliance
with 42 CFR Part 483 which is incorporated by
reference, including subsequent amendments.
Copies of the Code of Federal Regulations may be
purchased from the Superintendent of Documents,
U.S. Government Printing Office. Washington.
D.C. 20402 for thirty eight dollars ($38.00) and
may be purchased with a credit card by a direct
telephone call to the G.P.O. at (202) 783-3238.
"Nurse aide trainee" means a person who has not
completed an approved nurse aide training course
and competency evaluation and is demonstrating
knowledge, while performing tasks for which they
have been found proficient by an instructor.
These tasks shall be performed under the direct
supervision of a registered nurse. The term does
not apply to volunteers.
"Nursing facility" means a nursing home as
defined in G.S. 131E-104.
" Nurse-in -charge " means the nurse to whom
duties for a specified number of patients and staff
for a specified period of time have been delegated,
such as for Unit A on the 7^3 or 3-11 shift.
"Occupational therapist" means a person licensed
in the State of North Carolina as an occupational
therapist in accordance with the provisions of G.S.
90, Article 18D.
"Occupational therapist assistant" means a person
licensed in the State of North Carolina as an
occupational therapist assistant in accordance with
the provisions of G.S. 90. Article 18D.
"On-duty personnel" means personnel who are
responsive to patient needs and physically present
in the facility performing assigned duties.
"Patient" means any person admitted for nursing
care.
"Pharmaceutical care" means the provision of
drug therapy and other pharmaceutical care ser-
vices to achieve intended medication outcomes and
minimize negative effects of drug therapy.
"Pharmacist" means a person who is licensed to
practice pharmacy in North Carolina.
"Physician" means a person licensed under G.S.
90. Article J. to practice medicine in North Caro-
lina.
" Proposal " means a Negative Action Proposal
containing information that may ultimately be
classified as violations.
"Provisional License" means an amended license
recognizing significantly less than full compliance
with the licensure rules.
"Psychologist" means a person licensed as a
91
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
I
I
£49}
(50)
(51)
(52)
(53)
(54)
(55)
(56)
>
(57)
(58)
(59)
(60)
(61)
practicing psychologist in accordance with G.S.
90. Article 18 A.
"Physiatrist" means a licensed physician who has
completed a physical medicine and rehabilitation
residency training program a pproved by the
Accrediting Council of Graduate Medical Educa-
tion or the American Steopathic Association.
"Physical therapist" means a person licensed in the
State of North Carolina as a physical therapist in
accordance with the provisions of G.S. 90. Article
18B.
"Physical therapist assistant" means a person
licensed in the State of North Carolina as a physi-
cal therapist assistant in accordance with the
provisions of G.S. 90-270.24. Article 18B.
"Recreational therapist" means a person certified
by the State of North Carolina Therapeutic Recre-
ational Certification Board.
"Registered Nurse" means a nurse who is licensed
as a registered nurse under G.S. 90. Article 9A.
"Registered Records Administrator" means a
person who is registered by the American Medical
Record Association.
"Rehabilitation nurse" means a registered nurse
licensed in North Carolina, with training, either
academic or on- the-iob. in physical rehabilitation
nursing and at least one year experience in physi-
cal rehabilitation nursing.
"Rehabilitation aide" means an unlicensed assistant
who works under the supervision of a registered
nurse, licensed physical therapist or occupational
therapist in accordance with the appropriate
occupational licensure laws governing his or her
supervisor and consistent with staffing require-
ments as set forth in Rule .3027 of this Subchap-
ter. Any rehabilitation aide, who works in a
nursing department and is under the supervision of
a registered nurse, shall be listed on the North
Carolina Nurse Aide Registry and have received
additional staff training as listed in Rule .3028 of
this Subchapter.
"Rehabilitation physician" means a physiatrist or
a physician who is qualified, based on education,
training and experience, regardless of specialty, to
providing medical care to rehabilitation patients.
"Remodeling" means alterations, renovations,
rehabilitation work, repairs to structural systems.
and replacement of building systems at a nursing
facility.
"Resident" means any person admitted for care to
a domiciliary home part of a combination facility
as defined in G.S. 131E-101.
"Respite care" means services provided for per-
sons admitted to a nursing facility on a temporary
basis, not to exceed 30 days.
"Significant medication error" means an error
which causes the patient discomfort or jeopardizes
the health and safety of the patient. Factors to
consider when determining significance of error
include the patient's condition, the drug category
(need titration of blood levels, etc.) and frequency
of the error.
(62) "Single unit or unit dose package" means each
dose of medication is individually packaged in a
properly sealed and properly labeled container in
accordance with the U.S. Pharmacopeia and
professional standards.
(63) "Sitter" means an employee or volunteer who
provides companionship and social interaction to
a particular patient, usually on a private duty
basis.
(64) "Social worker" means a person who meets the
qualifications set forth in Rule .2902 of this
Subchapter.
(65) "Speech and language pathologist" means a person
licensed ui the State of North Carolina as a speech
and language pathologist in accordance with the
provisions of G.S. 90. Article 22.
(66) " Supervisor-in -charge " (domiciliary home) means
any employee to whom supervisory duties for the
domiciliary home portion of a combination home
have been delegated by either the administrator or
director of nursing.
(67) "Surveyor" means an authorized representative of
the Department who inspects nursing facilities and
combination facilities to determine compliance
with rules as set forth in G.S. 131E-1 17 and
applicable state and federal laws, rules and regula-
tions.
(68) "Unit dose system" means a drug distribution
system in which each dose of medication is con-
tained in. and administered from, single unit or
unit dose packages.
(69) "Ventilator dependence" is defined as physiologi-
cal dependency by a patient on the use of a venti-
lator for more than eight hours a day.
(70) "Violation" means a finding which directly relates
to a patient's or resident's health, safety or wel-
fare, or which creates a substantial risk that death
or serious physical harm will occur. It is deter-
mined to be an infraction of the regulations,
standards and requirements set forth in G.S. 131E
-117 and 131D-21 or applicable state and federal
laws, rules and regulations.
Statutory Authority G.S. 13 IE- 104.
SECTION .2100 - LICENSURE
.2101 APPLICATION REQUIREMENTS
(a) An application for licensure for a new facility shall be
submitted to the Medical Facilities Licensure Section of the
Division of Facility Services at least 30 days prior to a
license being issued or patients admitted.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
92
PROPOSED RULES
£b} The
01
01
01
££>
£51
(61
£21
£81
£21
a pplication shall contain the following :
legal identity of a pplicant (licensee) and mailing
address;
name or names under which the facility is
presented to the public;
location and mailing address of facility;
ownership disclosure;
accreditation data;
bed compliment;
magnitude and scope of services offered;
name and current license number of the adminis-
trator; and
name and current license number of the director
of nursing.
Statutory Authority G.S. 131E-104.
.2102 ISSUANCE OF LICENSE
(a) Only one license shall be issued to each facility. The
Department shall issue a license to the licensee of the
facility following review of operational policies and proce-
dures and verification of compliance with applicable laws
and rules.
£b) Licenses are not transferable.
(c) The bed capacity and services provided in a facility
shall be in compliance with G.S. 131E, Article 9 regarding
Certificate of Need.
(d) The license shall be posted in a prominent location.
accessible to public view, within the licensed premises.
Statutory Authority G.S. 131E-104.
.2103 LENGTH OF LICENSURE
Licenses shall remain in effect up. to .12 months, unless
any of the following occurs:
(1) Department imposes an administrative sanction
which specifies license expiration;
closure;
m
£4j
£5}
£6}
change of ownership;
change of site;
change in bed compliment; or
failure to comply with Rule .2104 of this Section.
Statutory Authority G.S. 13 IE- 104.
.2104 REQUIREMENTS FOR LICENSURE
RENEWAL OR CHANGES
(al The Department shall renew the facility's license at
the end of each calendar year, if the following occur:
(1) The licensee maintains and submits to the De-
partment, at least 30 days prior to the licensure
expiration date, statistical data for the State's
medical facilities plan and review for certificate
of need determination. The Department shall
provide forms annually to the facility for this
purpose.
(2) The facility is in conformance with G.S.
131E-102(c). "
£21
£21
£41
(b) The Medical Facilities Licensure Section of the
Division of Facility Services shall be notified in writing and
changes made in the licensure application at least 30 days
prior to the occurrence of the following:
(1) a change in the name or names under which the
facility is presented to the public:
a change in the legal identity (licensee) which
has ownership responsibility and liability (such
information shall be submitted by the proposed
new owner):
a change in the licensed bed capacity; or
a chang e in the location of the facility.
The Department shall issue a new license following notifica-
tion and verification of data submitted.
(c) The facility shall notify the Medical Facilities Licen-
sure Section of the Division of Facility Services within one
working day following the occurrence of:
(1) change in administration;
change in the director of nursing;
change in facility mailing address or telephone
number;
changes in magnitude or scope of services; or
emergencies or situations requiring relocation of
patients to a temporary location away from the
facility.
£21
£21
£41
£51
Statutory Authority G.S. 131E-104.
.2105 TEMPORARY CHANGE IN BED CAPACITY
(a) A life care center, having an agreement to care for all
residents regardless of level of care needs, may temporarily
increase bed capacity by 10 percent or 10 beds, whichever
is less, over the licensed bed capacity for a period up to 30
days following notification of and a pproval by the Depart-
ment.
(b) A facility other than a life care center or combination
home shall accept no more patients or residents than the
total number for which it is licensed except in an emergency
situation a pproved and confirmed in writing by the Medical
Facilities Licensure Section of the Division of Facility
Services. Emergency authorizations shall not exceed 30
calendar days and shall not exceed the total licensed bed
capacity for the facility.
(c) The Department shall authorize, in writing, a tempo-
rary increase in licensed beds in accordance with Paragraphs
(a) and (b) of this Rule, if it is determined that:
(1) the increase is not associated with a capital
expenditure; and
(2) the increase would not jeopardize the health,
safety and welfare of the patients.
Statutory Authority G.S. 13 IE- 104.
.2106 DENIAL, AMENDMENT, OR REVOCATION
OF LICENSE
(a) The Department shall deny any licensure a pplication
upon becoming aware that the a pplicant is not in compliance
with G.S. 131E. Article 9 and the rules adopted under that
93
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
law.
(b) The Department may amend a license by reducing it
from a full license to a provisional license whenever the
Department finds that:
(1) the licensee has substantially failed to comply
with the provisions of G.S. 131E. Article 6 and
the rules promulgated under that article;
(2) there is a reasonable probability that the licensee
can remedy the licensure deficiencies within a
reasonable length of time; and
(3) there is a reasonable probability that the licensee
will be able thereafter to remain in compliance
with the licensure rules for the foreseeable
future.
(c) The Department shall give the licensee written notice
of the amendment to the license. This notice shall be given
personally or by certified mail and shall set forth:
(1) the length of the provisional license;
(2) the factual allegations:
(3) the statutes or rules alleged to be violated; and
(4) notice of the facility's right to a contested case
hearing on the amendment of the license.
(d) The provisional license shall be effective immediately
upon its receipt by the licensee and shall be posted in a
prominent location within the facility, accessible to public
view, in lieu of the full license. The provisional license
shall remain in effect until:
(1) the Department restores the licensee to full
licensure status; or
£2} the Department revokes the licensee's license.
(e) If a licensee has a provisional license at the time the
licensee submits the annual utilization data, the provisional
license shall remain in effect unless the Department deter-
mines that the licensee can be returned to full licensure
status.
(f) The Department may revoke a license whenever:
(1) The Department finds that:
(A) the licensee has substantially failed to comply
with the provisions of G.S. 131E. Article 6
and the rules promulgated under that article;
and
(B) it is not reasonably probable that the licensee
can remedy the licensure deficiencies within a
reasonable length of time: or
(2) The Department finds that:
(A) the licensee has substantially failed to comply
with the provisions of G.S. 131E. Article 6;
and
(B) although the licensee may be able to remedy
the deficiencies within a reasonable time, it is
not reasonably probable that the licensee will
be able to remain in compliance with licensure
rules for the foreseeable future: or
(3) The Department finds that there has been any
failure to comply with the provisions of G.S.
131E. Article 6 and the rules promulgated under
that article that endanger the health, safety or
welfare of the patients in the facility.
(g~) The issuance of a provisional license is not a proce-
dural prerequisite to the revocation of a license pursuant to
Paragraph (f) of this Rule.
(h) The Department can, in accordance with G.S.
131E-232. petition to have a temporary manager a ppointed
to operate a facility.
Statutory Authority G.S. 131E-104.
.2107 SUSPENSION OF ADMISSIONS
(a) The Department may suspend the admission of any
new patient to any facility when warranted under the
provisions of G.S. 131E-109(c).
(b) The Department shall notify the facility personally or
by certified mail of the decision to suspend admissions-
Such notice shall include:
(1) factual allegations:
(2) citation of statutes and rules alleged to be vio-
lated: and
(3) notice of the facility's right to a contested case
hearing on the suspension.
(c) The suspension shall be effective when the notice is
served or on the date specified in the notice of suspension,
whichever is later. The suspension shall remain effective
until the facility demonstrates to the Department that
conditions are no longer detrimental to the health and safety
of the patients.
(d) The facility shall not admit new patients during the
effective period of the suspension.
(e) Patients requiring hospitalization during the period of
suspension of admissions shall be readmitted after hospital-
ization or on return from temporary care to the facility
based on the availability of a bed and the ability of the
facility to provide necessary care. Upon return from the
hospital, the requirements of G.S. 131E-130 shall a pply.
Statutory Authority G.S. 131E-104.
.2108 PROCEDURE FOR APPEAL
(a) The facility may appeal any decision of the Depart-
ment to deny, revoke or alter a license or any decision to
suspend admissions by making such an a ppeal in accordance
with G.S. 150B and 10 NCAC IB .0200.
(b) A decision to issue a provisional license is stayed
during the pendency of an administrative a ppeal and the
licensee may continue to display full license during the
a ppeal .
Statutory Authority G.S. 13 IE- 104.
.2109 INSPECTIONS
(a) The facility shall allow inspection by an authorized
representative of the Department at any time.
(b) At the time of inspection, any authorized representa-
tive of the Department shall make his or her presence
known to the administrator or other person in charge who
10:2
NORTH CAROLINA REGISTER
April 17, 1995
94
PROPOSED RULES
shall cooperate with the representative and facilitate the
inspection.
(c") Inspections of medical records will be carried out in
accordance with G.S. 131E-105.
£d) The administrator shall provide and make available to
representatives of the Department financial and statistical
records required to verify compliance with all rules con-
tained in this Subchapter.
(e) The Department shall mail a written report to the
facility within 10 working days from the date of the licen-
sure survey or complaint investigation exit conference. The
report shall include statements of any deficiencies or
violations cited during the survey or investigation.
£f) The administrator shall prepare a written plan of
correction and mail it to the Department within 10 working
days following receipt of any statement of deficiencies or
violations. The Department shall review and accept or
reject the plan of correction, with written notice given to the
administrator within 10 working days following receipt of
the plan.
Statutory Authority G.S. 131E-104.
.2110 PUBLIC ACCESS TO DEPARTMENT
LICENSURE RECORDS
(a) All Department files pertaining to the licensure of any
facility under this Subchapter shall be open for inspection by
any member of the public during normal business hours.
The Department shall have an opportunity to ensure that
none of the information identified in Paragraph (b) of this
Rule will be disclosed during the inspection. Except for
information identified in Paragraph (b) of this Rule, any
member of the public may obtain copies of any information
contained in the Department licensure files in accordance
with Division of Facility Services Directive 30. Publication
Guidelines, which is incorporated by reference, including
subsequent amendments. A copy of the directive may be
obtained, without charge, from the Medical Facilities
Licensure Section. Division of Facility Services. P.O. Box
29530. Raleigh. NC 27626-0530.
(b) Unless disclosure is ordered by a court of competent
jurisdiction, the following classes of information shall not be
disclosed to members of the public:
(1) information about the diagnosis, prognosis,
treatment, or any other confidential medical
information under G.S. 8-53. regarding a named
person, unless that person consents in writing to
the disclosure;
(2) the name of any person who provided informa-
tion concerning a facility licensed under this
Subchapter, or registered a complaint about the
treatment of a patient unless that person consents
to the disclosure;
(3) information identifying any person as a recipient
of public assistance or social services, unless
that person consents to the disclosure; and
£4} any confidential communication between the
attorney for the Department and the Department.
(c) When documents in the file contain only confidential
information of the types identified in Paragraph (b) of this
Rule, then they shall be removed from the file before
inspection. If a document contains both information of
those types identified in Paragraph (b) of this Rule and
non-confidential information, then the Department will
provide for inspection a copy of the document from which
the confidential information is deleted, in lieu of the original
document.
Statutory Authority G.S. 8-53; 108A-80; 131E-104;
131E-124(c); 132-1.1.
SECTION .2200 - GENERAL STANDARDS OF
ADMINISTRATION
.2201 ADMINISTRATOR
(a) The facility shall be under the direct management
control of an administrator. The administrator shall not
serve simultaneously as the director of nursing.
(b) If an administrator is not the sole owner of a facility,
his or her authority and responsibility shall be clearly
defined in a written agreement or in the facility's governing
bylaws.
(c) The administrator shall be responsible for the opera-
tion of a facility on a full-time basis.
(d) The administrator shall ensure patient services are
provided in accordance with all a pplicable local, state and
federal regulations and codes, and with acceptable standards
of practice that apply to professionals providing such
services in the facility.
(e) The administrator shall be responsible for developing
and implementing policies for the management and operation
of the facility.
(f) In the temporary absence of the administrator, a
person shall be on-site who is designated to be in charge of
the overall facility operation.
Statutory Authority G.S. 90-284; 131E-104.
.2202 ADMISSIONS
(a) No patient shall be admitted except by a physician or
other persons legally authorized to admit patients. Admis-
sion shall be in accordance with facility policies and
procedures.
(b) The administrator shall ensure patients receive
communicable disease screening, including tuberculosis, in
accordance with Rule .2209 of this Section.
(c) The facility shall acquire, prior to or at the time of
admission, orders from the attending physician for the
immediate care of the patient.
(d) Within 48 hours of admission, the facility shall
acquire medical information which shall include current
medical findings, diagnosis, and a summary of the hospital
stay if the patient is being transferred from a hospital.
£e} If a patient is admitted from somewhere other than a
hospital, the facility shall acquire a copy of the patient's
most recent medical history and physical, which shall have
♦
95
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
been updated within the preceding six months.
(f) Only persons who are 18 years of age or older shall
be admitted to the domiciliary portion of a combination
facility.
Statutory Authority G.S. 131E-104.
.2203 PATIENTS NOT TO BE ADMITTED
(a) Patients who require health, habilitative or rehabilita-
tive care or training beyond those for which the facility is
licensed and is capable of providing shall not be admitted.
(b) No person requiring continuous nursing care shall be
admitted to a domiciliary bed in a combination facility.
Should an existing resident of a domiciliary bed require
continuous nursing care, the administrator shall provide the
next available nursing facility bed (that is not needed to
comply with G.S. 131E-130) to the resident to ensure
continuity of care and to prevent discharge from the facility.
Statutory Authority G.S. 131E-104.
.2204 RESPITE CARE
(a) Respite care is not required as a condition of licen-
sure. Facilities providing respite care, however, shall meet
the requirements of this Subchapter with the following
exceptions: Rules .2205. .2301. and .25010)) and (c) of this
Subchapter.
(b) Facilities providing respite care shall meet the
following additional requirements:
(1) A patient's descriptive record of stay shall
include the preadmission or admission assess-
ment, interdisciplinary notes as warranted by
episodic events, medication administration
records and a summary of the stay u pon dis-
charge.
(2) The facility shall complete a preadmission or
admission assessment which allows for the
development of a short-term plan of care and is
based on the patient's customary routine. The
assessment shall address needs, including but not
limited to identifying information, customary
routines, hearing, vision, cognitive ability,
functional limitations, continence, special proce-
dures and treatments, skin conditions, behavior
and mood, oral and nutritional status and medi-
cation regimen. The plan shall be developed to
meet the respite care patient's needs.
(3) The attending physician of the respite care
patient will be notified of any acute changes or
acute episode which warrant medical involve-
ment. Medical orders and progress notes shall
be written following the physician's visits.
Statutory Authority G.S. 13 IE- 104.
.2205 DISCHARGE OF PATIENTS
(a) The facility shall ensure a medical order for discharge
is obtained for all patients except when a patient leaves
against medical advice or is discharged for non-payment.
(b) The facility shall ensure discharge planning is accom-
plished according to each patient's needs when a discharge
is anticipated.
(c) The facility shall ensure the patient or the legal
representative is informed and included in the discharge
planning process.
Statutory Authority G.S. 131E-104.
.2206 MEDICAL DIRECTOR
(a) The facility shall designate a physician to serve as
medical director.
(b) The medical director shall be responsible for imple-
mentation of patient care policies and coordination of
medical care in the facility.
Statutory Authority G.S. 13 IE- 104.
.2207 PATENT RIGHTS
(a) The facility shall enforce the Nursing Facility Pa-
tient's Bill of Rights as described in G.S. 1 31E-115 through
G.S. 131E-127.
(b) In matters of patient abuse, neglect or misappropria-
tion the definitions shall have the meaning defined in Rule
.2001 of this Subchapter.
Statutory Authority G.S. 13 IE- 104; 131E-131.
.2208 SAFETY
(a) The facility shall have detailed written plans and
procedures to meet potential emergencies and disasters,
including but not limited to fire, severe weather and missing
patients or residents.
(b) The plans and procedures shall be made available
upon request to local or regional emergency management
offices.
(c) The facility shall provide training for all employees in
emergency procedures upon employment and annually.
(d) The facility shall conduct unannounced drills using the
emergency procedures.
(e) The facility shall ensure that:
(1) the patients' environment remains as free of
accident hazards as possible; and
(2) each patient receives adequate supervision and
assistance to prevent accidents.
Statutory Authority G.S. 13 IE- 104.
.2209 INFECTION CONTROL
(a) The facility shall establish and maintain an infection
control program for the purpose of providing a safe, clean
and comfortable environment and preventing the transmis-
sion of diseases and infection.
(b) Under the infection control program, the facility shall
decide what procedures, such as isolation techniques, are
10:2
NORTH CAROLINA REGISTER
April 17, 1995
96
PROPOSED RULES
needed for individual patients, investigate all episodes of
infection and attempt to control and prevent infections in the
facility.
(c) The facility shall maintain records of all infections and
of the corrective actions taken.
(d) The facility shall ensure communicable disease
screening, including tuberculosis, prior to admission of all
patients and within seven days upon the hiring of all staff;
and tuberculosis screening annually thereafter for patients
and staff as required by 15A NCAC 19A .0101 "Communi-
cable Disease Control " which is incorporated by reference,
including subsequent amendments. Copies of these Rules
may be obtained at no charge by contacting the N.C.
Department of Environment. Health, and Natural Resources.
Tuberculosis Control branch. P.O. Box 27687. Raleigh.
North Carolina 27611-7687. Identification of a communica-
ble disease does not, in aH cases, in and of itself, preclude
admission to the facility.
(e) All cases of reportable disease as defined by 15A
NCAC 19A "Communicable Disease Control" and epidemic
outbreaks, and poisonings shall be reported immediately to
the local health department.
(f) The facility shall isolate any patient deemed appropri-
ate by the infection control program.
(g) The facility shall prohibit any employee with a
communicable disease or infected skin lesion from direct
contact with patients or their food, if direct contact is the
mode of transmission of the disease.
(h) The facility shall require all staff to use good hand
washing technique as indicated by accepted professional
practice.
(i) All linen shall be handled, store, processed and
transported so as to prevent the spread of infection.
Statutory Authority G.S. 13 IE- 104.
.2210 REPORTING AND INVESTIGATING
ABUSE, NEGLECT OR
MISAPPROPRIATION
(a) The facility shall take reasonable measures to prevent
patient abuse, patient neglect, or misappropriation of patient
property, including but not limited to orientation and
instruction of facility staff on patients' rights, and the
screening of and requesting of references for all prospective
employees.
(b) The administrator shall ensure that the Complaint
Investigation Branch of the Division of Facility Services is
notified within 24 hours or as soon as practicable of all
allegations which a ppear to a reasonable person to be related
to patient abuse, neglect or misappropriation of patient
property.
(c) The facility shall thoroughly investigate allegations of
patient abuse, patient neglect, or misappropriation of patient
property in accordance with 42 CFR subsection 483.13
which is incorporated by reference, including subsequent
amendments, and shall document all relevant information
pertaining to such investigation and shall take whatever steps
are necessary to prevent further incidents of abuse, neglect
or misappropriation of patient property while the investiga-
tion is in progress. Copies of the Code of Federal Regula-
tions may be purchased from the Superintendent of Docu-
ments. U.S. Government Printing Office. Washington. D.C.
20402 for thirty eight dollars ($38.00*) and may be pur-
chased with a credit card by a direct telephone call to the
G.P.O. at (202) 783-3238.
(d) The administrator shall ensure that the report of
investigation is printed or typed and postmarked to the
Complaint Investigation Branch of the Division of Facility
Services within five working days of the allegation. The
report shall include the date and time of the alleged incident
of abuse, neglect or misappropriation of property; the
patient's full name and room number; details of the allega-
tion and any injury; names of the accused and any wit-
nesses; names of the facility staff who investigated the
allegation; results of the investigation: and any corrective
action that may have been taken by the facility.
Statutory Authority G.S. 131E-104; 131E-111; 131E-131.
.2211 PERSONNEL STANDARDS
(a) The facility shall employ the types and numbers of
professional and non-professional staff to ensure the health,
safety and proper care of patients.
(1) Each employee shall be assigned duties consis-
tent with his or her job description and with his
or her level of education and training.
(2) Professional staff shall be licensed, certified or
registered in accordance with a pplicable state
laws.
(3) The facility shall provide orientation regarding
facility policies and procedures for all staff upon
employment.
(4) The facility shall train all staff periodically in
accordance with their j ob duties.
(b) The facility shall maintain an individual personnel
record for each employee, including verification of creden-
tials.
(c) The facility shall have a written agreement with any
nursing personnel agency providing staff to the facility and
shall ensure orientation of agency staff who work in the
facility.
Statutory Authority G.S.131E-104.
.2212 QUALITY ASSURANCE COMMITTEE
(a) The administrator shall ensure that a quality assess-
ment and assurance committee is actively maintained and
consists of the director of nursing, a physician designated by
the facility, a pharmacist and at least three other staff
members.
(b) The committee shall meet at least quarterly.
(c) The committee shall develop and implement appropri-
ate plans of action which will correct identified quality care
problems.
Statutory Authority G.S. 13 IE- 104.
91
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
SECTION .2300 - PATIENT AND RESIDENT
CARE AND SERVICES
.2301 PATIENT ASSESSMENT AND CARE
PLANNING
(a) At the time each patient is admitted, the facility shall
ensure physician orders are available for the patient's
immediate care and that, within 24 hours, a nursing assess-
ment of immediate needs is completed by a registered nurse
and measures implemented as a ppropriate.
(b) The facility shall perform, within 14 days of admis-
sion and at least annually, a comprehensive, accurate,
documented assessment of each patient's capability to
perform daily life functions. This comprehensive assess-
ment shall be coordinated by a registered nurse and shall
include at least the following:
(1) current medical diagnoses;
(2) medical status measurements, including current
cognitive status, stability of current conditions
and diseases, vital signs, and abnormal lab
values and diagnostic tests that are a part of the
medical history;
(3) the patient's ability to perform activities of daily
living, including the need for staff assistance and
assistive devices, and the patient's ability to
make decisions;
(4) presence of neurological or muscular deficits;
(5) nutritional status measurements and require-
ments, including but not limited to height,
weight, lab work, eating habits and preferences,
and any dietary restrictions;
(6) special care needs, including but not limited to
pressure sores, enteral feedings, specialized
rehabilitation services or respiratory care;
(7) indicators of special needs related to patient
behavior or mood, interpersonal relationships
and other psychosocial needs;
(8) facility's expectation of discharging the patient
within the three months following admission;
(9) condition of teeth and gums, and need and use
of dentures or other dental a ppliances;
(10) patient's ability and desire to take part in activi-
ties, including an assessment of the patient's
normal routine and lifetime preferences;
(11) patient's ability to improve in functional abilities
through restorative care; and
(12) presence of visual, hearing or other sensory
deficits.
(c) The facility shall develop a comprehensive care plan
for each patient and shall include measurable objectives and
timetables to meet needs identified in the comprehensive
assessment. The facility shall ensure the comprehensive
care plan is developed within seven days of completion of
the comprehensive assessment by an interdisciplinary team
that includes a nurse with responsibility for the patient and
representatives of other appropriate disciplines as dictated by
the needs of the patient. To the extent practicable, prepara-
tion of the comprehensive care plan should include the
participation of the patient and the patient's family or legal
representative. The physician may participate by alternative
methods, including, but not limited to. telephone or
face-to-face discussion, or written notice.
(d) The facility shall review comprehensive assessments
and care plans no less frequently than once every 90 days
and make necessary revisions to ensure accuracy.
Statutory Authority G.S. 13 IE- 104.
.2302 NURSING SERVICES
(a) The facility shall designate a registered nurse to serve
as the director of nursing on a full-time basis.
(b) The director of nursing shall be responsible for the
administering of nursing services.
(c) The director of nursing may serve also as charge
nurse, only if the average daily occupancy is less than 60.
(d) The director of nursing shall not serve as administra-
tor, assistant administrator or acting administrator during an
employment vacancy in the administrator position.
Statutory Authority G.S. 131E-104.
.2303 NURSE STAFFING REQUD1EMENTS
(a) The facility shall provide licensed nursing personnel
consistent with applicable occupational regulations and
sufficient to accomplish the following:
(1) patient needs assessment;
(2) patient care planning; and
(3) supervisory functions in accordance with the
levels of patient care advertised or offered by
the facility.
£b) The facility shall provide other nursing personnel
sufficient to ensure that activities of daily living, personal
grooming, restorative nursing actions and other health care
needs, as identified in each patient's plan of care, are met.
(c) A multi-storied facility shall have at least one di-
rect-care staff member on duty on each patient care floor at
all times.
(d) Except for designated units with higher staffing
requirements noted elsewhere in this Subchapter, daily direct
patient care nursing staff, licensed and unlicensed, shall
equal or exceed 2.1 nursing hours per patient per day.
(This is sometimes referred to as nursing hours per patient
day or NHPPD or NH/PD.)
(1) Inclusive in these nursing hours is the require-
ment that at least one licensed nurse is on duty
for direct patient care at all times.
(2) Nursing care shall include the services of a
registered nurse for at least eight consecutive
hours a day, seven days a week. This coverage
can be spread over more than one shift if such a
need exists. The director of nursing may be
counted as meeting the requirements for both the
director of nursing and patient staffing for
10:2
NORTH CAROLINA REGISTER
April 17, 1995
98
PROPOSED RULES
facilities with a total census of 60 nursing beds
or less.
(31 Nursing support personnel, including ward
clerks, secretaries, nurse educators and persons
in primarily administrative management positions
and not actively involved in direct patient care,
shall not be counted toward compliance with
minimum daily requirements for direct care
staffing,
(e) An exception to meeting the minimum staffing
requirements shall be reported to the Department at the end
of each month. Staffing waivers granted by the federal
government for Medicare and Medicaid certified beds shall
be accepted for licensure purposes.
Statutory Authority G.S. 131E-104.
.2304 NURSE AIDES
(a) The facility shall employ or contract individuals as
nurse aides in compliance with 42 CFR Part 483 which is
incorporated by reference, including subsequent amend-
ments. Copies of the Code of Federal Regulations may be
purchased from the Superintendent of Documents, U.S.
Government Printing Office. Washington. D.C. 20402 for
thirty eight dollars ($38.00) and may be purchased with a
credit card by a direct telephone call to the G.P.O. at (202)
783-3238.
(b) The facility shall provide to the Department, upon
request, verification of in-service training and of past or
present employment of any nurse aide employed by the
facility.
Authority G.S. 131E-104; 131E-1U; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396.
.2305 QUALITY OF CARE
(a) The facility shall provide necessary care and services
in accordance with physician's orders, the patient's compre-
hensive assessment and on-going plan of care.
(b) Acute changes in the patient's physical, mental or
psychosocial status shall be evaluated and reported to the
physician.
(c) The facility shall not utilize any chemical or physical
restraints for the purpose of discipline or convenience, and
that are not required to treat the patient's medical condition.
An evaluation shall be done to ensure that the least restric-
tive means of restraint have been initiated on patients
requiring restraints.
(d) The facility shall ensure that all patients who are
unable to perform activities of daily living receive the
necessary assistance to maintain good grooming, and oral
and personal hygiene. The facility shall ensure a ppropriate
measures are taken to restore the patient's ability to bathe,
dress, groom, transfer and ambulate, toilet and eat.
(e) The facility shall ensure measures are taken to prevent
the formation of pressure sores and to promote healing of
existing pressure sores. The facility shall ensure that
patients with limited mobility receive a ppropriate care to
promote comfort and maintain skin integrity.
£f) The facility shall ensure that in -dwelling catheters are
not used unless the patient's clinical condition necessitates
their use. The facility shall ensure incontinent patients
receive appropriate treatment to prevent infections and to
regain continence to the degree possible.
(g) The facility shall ensure that patients with limited
range of motion, or who are at risk for loss of range of
motion, receive treatment services to prevent development
of contractures or deformities, and to obtain and maintain
their optimal level of functioning.
(h) The facility shall ensure that patients who are unable
to feed themselves receive the appropriate assistance,
retraining and assistive devices when needed.
£i) The facility shall ensure that enteral feeding tubes are
used only when the patient's condition indicates the use of
an enteral feeding tube is unavoidable.
(j) The facility shall ensure that patients fed by enteral
feeding tubes receive the proper treatment to avoid aspira-
tion pneumonia, metabolic and gastrointestinal problems,
and to restore the patient to the highest practicable level of
normal feeding function. The facility shall ensure a ppropri-
ate care and services are provided to address needs related
to hydration and nutrition.
(k) The facility shall ensure that patients requiring special
respiratory care receive a ppropriate services.
£1) The facility shall ensure that patients are assisted to
utilize personal visual lenses, hearing aids and dentures.
Statutory Authority G.S. 131E-104.
.2306 MEDICATION ADMINISTRATION
(a) The facility shall ensure that medications are adminis-
tered in accordance with standards of professional practice
and a pplicable occupational licensure regulations.
(b) The facility shall ensure that each patient's drug
regimen is free from drugs used in excessive dose or
duplicative therapy, for excessive duration or without
adequate indications for the prescription of the drug. Drugs
shall not be used without adequate monitoring or in the
presence of adverse conditions that indicate the drugs' usage
should be modified or discontinued.
(c) Antipsychotic therapy shall not be initiated on any
patient unless necessary to treat a clinically diagnosed and
clinically documented condition. When antipsychotic
therapy is prescribed, unless clinically contraindicated.
gradual dose reductions and behavioral interventions shall be
employed in an effort to discontinue these drugs.
(d) The facility shall ensure that procedures aimed at
minimizing medication error rates include, but are not
limited to. the following:
(1) All medications or drugs and treatments shall be
administered and discontinued in accordance
with signed physician orders which are recorded
in the patient's medical record. Such orders
shall be complete and include drug name,
strength, quantity to be administered, route of
administration, frequency and, if ordered on an
♦
99
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
m
££}
mi
£21
£5}
£6}
£21
£8J
as-needed basis, a clearly stated indication for
use.
The requirements for self-administration of
medication shall include, but not be limited to.
the following:
determination by the interdisciplinary team that
this practice is safe;
administration ordered by the physician;
specific instructions for administration printed
on the medication label; and
administration of medication monitored by the
licensed nursing staff and consultant pharma-
cist.
The administration of one patient's medications
to another patient is prohibited except in the case
of an emergency. In the event of such emer-
gency, steps shall be taken to ensure that the
borrowed medications are replaced promptly and
so documented.
Omission of medications and the reason for
omission shall be indicated in the patient's
medical record.
Medication administration records shall provide
time of administration, identification of the drug
and strength of drug, quantity of drug adminis-
tered, route of administration, frequency, name
of administering employee and title of employee-
Medication administration records shall indicate
documentation of injection sites and topical
medication sites requiring rotation, including,
but not limited to. transdermal medication.
The pharmacy shall receive an exact copy of
each physician's order for medications and
treatments-
Automatic stop orders for medications and
treatments shall be established and implemented.
The facility shall maintain an accountability of
controlled substances as defined by the North
Carolina Controlled Substances Act. G.S. 90.
Article 5.
Statutory Authority G.S. 13 IE- 104.
.2307 DENTAL CARE AND SERVICES
(a) The facility shall ensure that routine and emergency
dental services are available for all patients.
(b) The facility shall, if necessary, assist the patient in
making a ppointments and obtaining transportation to the
dentist's office-
supervisor in charge of the domiciliary beds.
(b) If domiciliary beds are located in a separate building
or a separate level of the same building, there shall be a
person on duty in the domiciliary portion of the facility at
all times.
(c) The facility shall comply with all rules in Subchapter
10 NCAC 42D. Licensing of Homes for the Aged and
Infirm, which is incorporated by reference, including all
subsequent amendments. Copies of these Rules can be
obtained free of charge from the Division of Facility
Services. Domiciliary and Group Care Section. P.O. Box
29530. Raleigh. NC 27626-0530.
Statutory Authority G.S. 131E-104.
SECTION .2400 - MEDICAL RECORDS
.2401 MAINTENANCE OF MEDICAL RECORDS
(a) The facility shall establish a medical records service.
It shall be directed, staffed and equipp ed to ensure:
(1) records are processed, indexed and filed accu-
rately;
(2) records are stored in such a manner as to pro-
vide protection from loss, damage or unautho-
rized use;
(3) records contain sufficient information to identify
the patient p lus a record of aU assessments; plan
of care: pre-admission screening, if a pplicable;
records of implementation of plan of care;
progress notes; and record of discharge, includ-
ing a discharge summary signed by the physi-
cian: and
(4) records are readily accessible by authorized
personnel.
(b) The facility shall ensure that a master patient index is
maintained, listing patients alphabetically by name, dates of
admission, dates of discharge and case number.
(c) The administrator shall designate an employee who
works full-time to be the medical records manager. The
manager shall advise, administer, supervise and perform
work involved in the development, analysis, maintenance
and use of medical records and reports. If that employee is
not qualified by training or experience in medical record
science, he or she shall receive consultation from a regis-
tered records administrator or an accredited medical record
technician to ensure compliance with rules contained in this
Subchapter. The facility shall provide orientation,
on-the-job training and in-service programs for all medical
records personnel.
Statutory Authority G.S. 131E-104.
.2308 DOMICILIARY HOME PERSONNEL
REQLTREMENTS
(a) The administrator shall designate a person to be in
charge of the domiciliary home residents at all times. The
nurse in charge of the nursing facility may also serve as
Statutory Authority G. S. 131E-104.
.2402 PRESERVATION OF MEDICAL RECORDS
(a) The manager of medical records shall ensure that
medical records, whether original, computer media or
microfilm, be kept on file for a minimum of jj. years
following the discharge of an adult patient.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
100
PROPOSED RULES
(b) The manager of medical records shall ensure that if
the patient is a minor, records shall be kept on file until his
or her 19th birthday and, then, for 11 years.
£c] If a facility discontinues operation, the licensee shall
make known to the Division of Facility Services where its
records are stored. Records are to be stored in a business
offering retrieval services for at least 11 years after the
closure date.
(d) Prior to destruction, public notice shall be made to
permit former patients or their representatives to claim their
own records. Public notice shall be in at least two forms.
£e} The manager of medical records may authorize the
microfilming of medical records. Microfilming may be
done on or off the premises. If done off the premises, the
facility shall take precautions to ensure the confidentiality
and safekeeping of the records. The original of the micro-
filmed medical records shall not be destroyed until the
manager of medical records has had an opportunity to
review the processed film for content.
(f) Nothing in this Subchapter shall be construed to
prohibit the use of automation of medical records, provided
that all of the provisions in this Rule are met and the
medical record is readily available for use in patient care.
£g) All medical records are confidential. Only authorized
personnel shall have access to the records. Signed authori-
zation forms concerning approval or disapproval of release
of medical information outside the facility shall be a part of
each patient's medical record. Representatives of the
Department shall be notified at the time of inspection of the
name and record number of any patient who has denied
medical record access to the Department.
(h) Medical records are the property of the facility, and
thev shall not be removed from the facility except through
a court order. Copies shall be made available for authorized
purposes such as insurance claims and physician review.
Statutory Authority G.S. 13 IE- 104.
SECTION .2500 - PHYSICIAN'S SERVICES
.2501 AVAILABILITY OF PHYSICIAN'S
SERVICES
(a) The facility shall ensure each patient's care is super-
vised by a physician and that provisions are made for
emergency physicians when attending physicians are
unavailable. The names and telephone numbers of the
designated physicians shall be posted at each nurse's station.
(b) Patients shall be seen by a physician at least once
every 30 days for the first 90 days and at least every 60
days thereafter. Following the first 90 days, the physician
may delegate this responsibility to a physician assistant or
nurse practitioner every other visit. A physician's visit is
considered timely if the visit occurs not later than 10 days
after the visit was required.
(c) Physicians shall review the patient's medical plan of
care, write or dictate and sign progress notes; and sign and
date all current orders at each visit.
(d) A physician's oral orders, including telephone orders.
shall be given only to a nurse or other licensed professional
who by law is allowed to accept physician's orders, except
orders for therapeutic diets which shall be given either to a
qualified dietitian or licensed nurse. The record of each
telephone order shall include the name of physician giving
the order, date and time of order, content of order and name
of person receiving the order. The physician who gives oral
orders shall sign the orders within five days.
Statutory Authority G.S. 131E-104.
.2502 PRIVATE PHYSICIAN
(a) Each patient or legal representative shall be allowed
to select his or her private physician except in those facili-
ties affiliated with medical teaching programs and having
written policies requiring all patients to participate in the
medical teaching program.
fb) The private physician shall fulfill given requirements
as determined by a pplicable state and federal regulations,
and the facility's policies and procedures pertaining to
physician services.
(c) The facility shall have the right, after informing the
patient, to seek an alternative physician, when requirements
are not being met and to ensure that the patient is provided
with appropriate, adequate care and treatment.
Statutory Authority G.S. 131E-104.
.2503 USE OF NURSE PRACTITIONERS AND
PHYSICIAN ASSISTANTS
(a) If a facility employs physician assistants or nurse
practitioners it shall maintain the following information for
each nurse practitioner and physician assistant:
(P a statement of a pproval to practice as a nurse
practitioner by the Board of Medical Examiners
and Board of Nursing for each practitioner, or a
statement of a pproval to practice as a physician
assistant by the Board of Medical Examiners for
each physician assistant;
(2) an approved annual renewal form; and
(3) a copy of instructions or protocols signed by the
nurse practitioner or physician assistant and the
supervising physicians.
fb) The privileges of the nurse practitioner or physician
assistant shall be clearly defined by the facility's policies
and procedures and shall be limited to those privileges
authorized in 21 NCAC 32M for the nurse practitioner or
21 NCAC 32Q for the physician assistant which are hereby
incorporated by reference including subsequent amendments.
Copies of the rules may be obtained from the North Caro-
lina Board of Medical Examiners, PO Box 20007, 1203
Front Street, Raleigh, NC 27619, at no charge.
Statutory Authority G.S. 131E-104.
.2504 LABORATORY AND RADIOLOGY
SERVICES
The facility shall provide or obtain clinical laboratory and
«
101
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
radiology services to ensure that each patient's needs are
met. Such services shall include the following:
(1) provision of laboratory and radiology services
within the facility or by contractual agreement;
£2) diagnostic testing to be don e only in accordance
with a physician's order;
(3) reports to be dated once filed in the patient's
medical record:
(4) notification of the physician regarding findings;
and
(5) assistance in arranging transportation for the
patient when testing must be done other than in
the facility.
Statutory Authority G.S. 131E-104.
.2505 BRAIN INJURY LONG-TERM CARE
PHYSICIAN SERVICES
(a) For facility patients located in designated brain injury
long-term care units, there shall be an attending physician
who is responsible for the patient's specialized care pro-
gram. The intensity of the program requires that there shall
be direct patient contact by a physician at least once per
week and more often as the patient's condition warrants.
Each patient's interdisciplinary, rehabilitation program shall
be developed and implemented under the supervision of a
phvsiatrist £a physician trained in physical medicine and
rehabilitation) or a physician of equivalent training and
experience.
£b) If a phvsiatrist or physician of equivalent training or
experience is not available on a weekly basis to the facility,
the facility shall provide for weekly medical management of
the patient b y another physician. In addition, oversight for
the patient's interdisciplinary, long-term care program shall
be provided by a qualified consultant physician who visits
patients monthly, makes recommendations for and a pproves
the interdisciplinary care plan, and provides consultation as
requested to the physician who is managing the patient on a
weekly basis.
(c) The attending physician shall actively participate in
individual case conference or care planning sessions and
shall review and sign discharge summaries and records
within 15 days of a patient discharge. When patients are to
be discharged to either another health care facility or a
residential setting, the attending physician shall ensure that
the patient has been provided with a discharge plan which
incorporates optimum utilization of community resources
and post discharge continuity of care and services.
Statutory Authority G.S. 131E-104.
.2506 PHYSICIAN SERVICES FOR VENTILATOR
DEPENDENT PATIENTS
Facilities with ventilator dependent care patients shall
contract with a physician who has specialized training in
pulmonary medicine. This physician shall be responsible
for respiratory services and shall:
ill
(1)
£4}
establish, with the respiratory therapist and nurs-
ing staff, a ppropriate ventilator policies and
procedures, including emergency procedures;
assess each ventilator-dependent patient's status at
least monthly with corresponding progress notes;
be available on a emergency basis; and
participate in individual patient care planning.
Statutory Authority G.S. 131E-104.
SECTION .2600 - PHARMACEUTICAL SERVICES
.2601 AVAILABHJTY OF PHARMACEUTICAL
SERVICES
(a) The facility shall provide pharmaceutical services
under the supervision of a qualified pharmacist, including
procedures that ensure the accurate acquiring, receiving and
administering of all drugs and biologicals.
(b) The facility shall be responsible for obtaining drugs,
therapeutic nutrients and related products prescribed or
ordered by a physician for patients in the facility.
(c) To ensure that drug therapy is rational, safe and
effective, a pharmaceutical care assessment shall be con-
ducted in the facility at least every 31 days for each patient.
All new admissions shall receive a pharmaceutical care
assessment at the time of the pharmacist's next visit or
within 31 days, whichever comes first. This assessment
shall include at least:
(1) a review of the patient's diagnoses, history and
physical, discharge summary, diet, vital signs,
current physician's orders, laboratory values,
progress notes, interdisciplinary care plans and
medication administration records; and
(2) the pharmacist's progress notes in the patient's
medical record which reflect the results of this
assessment and, if necessary, recommendations
for change based on desired drug outcomes.
Statutory Authority G.S. 13 IE- 104.
.2602 PHARMACY PERSONNEL
(a) If the pharmacist is an employee of the facility and
performs vending or clinical services, an up-to-date job
description and personnel file shall be maintained.
(b) If pharmaceutical vending or clinical services are
contracted, there shall be a current written agreement for
each service which includes a statement of responsibilities
for each party.
(c) The facility shall keep, or be able to make available.
a copy of the current license of the pharmacists.
Statutory Authority G.S. 13 IE- 104.
.2603 ADMINISTRATIVE RESPONSIBILITIES
(a) The pharmacist shall report any potential drug therap y
irregularities or discrepancies in drug accountability and
administration with recommendations for change to the
10:2
NORTH CAROLINA REGISTER
April 17, 1995
102
PROPOSED RULES
director of nursing and the attending physician. Recommen-
dations shall be communicated to the health care profession-
als in the facility who have the authority to effect a change.
These reports shall be submitted monthly following the
pharmacist's pharmaceutical care assessments.
(b) The administrator shall ensure documentation of
action taken relative to the pharmacist's reports.
Statutory Authority G.S. 13 IE- 104.
.2604 DRUG PROCUREMENT
(a) The facility shall not be permitted to possess a stock
of prescription legend drugs for general or common use
except as permitted by the North Carolina Board of Phar-
macy and as follows:
UU
Ml
15]
16}
for all intravenous and irrigation solutions in
single unit quantities exceeding 49 ml. and
related equipment for the use and administration
of such;
diagnostic agents;
vaccines;
drugs designated for inclusion in an a pproved
emergency kit;
water for injection; and
normal saline for injection.
(b) Patient Drugs:
(1) The contents of all prescriptions shall be kept in
the original container bearing the original label
as described in Subparagraph (b)(2) of this Rule.
(2) Except in a 72-hour or less unit dose system.
each individual patient's prescription or legend
drugs shall be labeled with the following infor-
mation:
(A) the name of the patient for whom the drug is
intended:
(B) the most recent date of issue;
(C) the name of the prescriber;
(D) the name and concentration of the drug, quan-
tity dispensed, and prescription serial number;
(E) a statement of generic equivalency which shall
be indicated if a brand other than the brand
prescribed is dispensed;
(F) the expiration date, unless dispensed in a
single unit or unit dose package;
auxiliary statements as required of the drug;
the name, address and telephone number of the
dispensing pharmacy; and
the name of the dispensing pharmacist.
(c) Non-legend drugs shall be kept in the original con-
tainer as received from the supplier and shall be labeled as
described in Subparagraph (b)(2) of this Rule or with at
least:
(1) the name and concentration of the drug, and
quantity packaged;
(2) the name of the manufacturer, lot number and
expiration date.
Statutory Authority G.S. 13 IE- 104.
10}
m
CD
.2605 DRUG STORAGE AND DISPOSITION
(a) The pharmacist and director of nursing shall ensure
that drug storage areas are clean, secure, well lighted and
well ventilated; that room temperature is maintained between
59 degrees F. and 86 degrees F.; and that the following
conditions are met:
(1) All drugs shall be maintained under locked
security except when under the immediate or
direct physical supervision of a nurse or pharma-
cist.
(2) Drugs requiring refrigeration shall be stored in
a refrigerator containing a thermometer and
capable of maintaining a temperature range of 2
degrees C to 8 degrees C. (36 degrees F. to 46
degrees F.) Drugs shall not be stored in a
refrigerator containing non-drug s and non-drug
related items, except when stored in a separate
container.
(3) Drugs intended for topical use, except for oph-
thalmic, otic and transdermal medications, shall
be stored in a designated area separate from the
drugs intended for oral and injectable use.
(4) Drugs that are outdated, discontinued or deterio-
rated shall be removed from the facility within
five days.
(b) Upon discontinuation of a drug or upon discharge of
a patient, the remainder of the drug supply shall be disposed
of promptly. If it is reasonably expected that the patient
shall return to the facility and that the drug therapy will be
resumed, the remaining drug supply may be held for not
more than 30 calendar day s after the date of discharge or
discontinuation.
(c) The disposition of drugs shall be in accordance with
written policies and procedures established by the Quality
Assurance Committee.
(d) Destruction of controlled substances shall be in
compliance with North Carolina Controlled Substance Act
and Regulations (10 NCAC 45G) which is hereby incorpo-
rated by reference including subsequent amendments.
Copies of the rules may be obtained from the Controlled
Substances Regulatory Branch. Division of Mental Health.
Developmental Disabilities and Substance Abuse Services.
325 N, Salisbury Street. Raleigh. NC 27603 at a cost of
thirteen dollars ($13.00).
Statutory Authority G.S. 131E-104.
.2606 PHARMACEUTICAL RECORDS
(a) The pharmacist shall ensure that accurate records of
the receipt, use and disposition of drugs are maintained and
readily available.
(b) The director of nursing and pharmacist shall ensure
accountability of controlled substances as defined by the
North Carolina Controlled Substances Act and Regulations
(10 NCAC 45G) which is hereby incorporated by reference
including subsequent amendments. Copies of the rules may
be obtained from the Controlled Substances Regulatory
♦
103
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
Branch. Division of Mental Health. Developmental Disabili-
ties and Substance Abuse Services. 325 N. Salisbury Street.
Raleigh. NC 27603 at a cost of thirteen dollars ($13.00).
Statutory Authority G.S. 13 IE- 104.
.2607 EMERGENCY DRUGS
(a) The facility shall maintain a supply of emergency
drugs in compliance with 21 NCAC 46 .1403 which is
hereby incorporated by reference including subsequent
amendments. Copies of the rule may be obtained from the
North Carolina Board of Pharmacy. P.O. Box 459.
Carrboro Plaza. Highway 54 Bypass. Carrboro. North
Carolina 27510 at a cost of eight dollars and forty eight
cents ($8.48).
(b) Emergency drugs shall be stored in a portable
container sealed with an easily breakable closure which
cannot be resealed or reused and shall be readily accessible
for use.
(c) Emergency drug kits shall be stored in a secure area
out of site of patients and the general public. If stored in a
locked area the kits shall be immediately accessible to all
licensed nursing personnel.
(d) All emergency drugs and quantity to be maintained
shall be a pproved by the Quality Assurance Committee.
(e) If emergency drug items require refrigerated storage,
they shall be stored in a separate sealed container within the
medication refrigerator. The container shall be labeled to
indicate the emergency status of the enclosed drug and
sealed as indicated in Paragraph (b) of this Rule.'
(f) An accurate inventory of emergency drugs and
su pplies shall be maintained with each emergency drug kit.
(g) The pharmacist shall personally examine the refriger-
ated and non-refrigerated emergency drug supply at least
every 90 days and make any necessary changes at that time.
(h) The facility shall have written policies and procedures
which are enforced to ensure that in the event the sealed
emergency drug container is opened and contents utilized,
immediate steps are taken to replace the items used.
(T) The availability of a controlled substance in an
emergency kit shall be in compliance with the North
Carolina Controlled Substances Act and Regulations (10
NCAC 45G) which is hereby incorporated by reference
including subsequent amendments. Copies of the rules may
be obtained from the Controlled Substances Regulatory
Branch. Division of Mental Health. Developmental Disabili-
ties and Substance Abuse Services. 325 N^ Salisbury Street.
Raleigh. NC 27603 at a cost of thirteen dollars ($13.00).
Statutory Authority G.S. 131E-104.
SECTION .2700 - DIETARY SERVICES
.2701 PROVISION OF NUTRITION AND DD2TETIC
SERVICES
(a) The facility shall ensure that each patient is provided
with a palatable diet that meets his or her daily nutritional
and specialized nutritional needs.
(b) The facility shall designate a person to be known as
the director of food service who shall be responsible for the
facility's dietetic service and for supervision of dietetic
service personnel. If this person is not a dietitian, he or she
shall meet the criteria for membership in the Dietary
Managers Association which is hereby incorporated by
reference including subsequent amendments and editions-
Copies of criteria may be obtained from the Dietary Manag-
ers Association. I Pierce Place. Suite 1220 West. Itasca.
Illinois. 60143 at no cost. If the course has not been
completed, this person shall be enrolled in a course and
making satisfactory progress for completion within the time
limit specified by course requirements.
(c) If the food service supervisor is not a dietitian, the
facility shall employ a dietitian on at least a consultant basis.
The consultant shall submit written reports to the Adminis-
trator and food service supervisor.
(d) The dietitian shall spend sufficient time in the facility
to assure the following parameters of nutrition have been
addressed and that recommended interventions meet stan-
dards of practice:
(1) An analysis of weight loss or gain:
Laboratory values:
Clinical indicators of malnutrition:
£21
01
£41
Drug therapy that may contribute to nutritional
deficiencies:
(5) The amount of meal and supplement consumed
to meet nutritional needs:
(6) Increased nutritional needs related to disease
state or deterioration in physical or mental
status, i.e.. decubitus, low protein status, inade-
quate intake, or nutrition provided via enteral or
parenteral route.
(e) There shall be sufficient dietet ic personnel employed
competent to meet the nutritional needs of all patients in the
areas of therapeutic diets, food preparation and service.
principles of sanitation, and resident's rights as related to
food services.
(f) The facility shall ensure that menus are followed
which meet the nutritional needs of patients in accordance
with the recommended dietary allowances of the Food and
Nutrition Board of the National Research Council. National
Academy of Sciences which are incorporated by reference,
including subsequent amendments. Copies of this publica-
tion can be obtained by contacting Printing and Publishing
Office. National Academy of Sciences. 2101 Constitution
Avenue. Washington. D.C. Cost of this publication is
eighteen dollars and ninety five cents ($18.95) and includes
shi pping and handling. Menus shall:
(1) be planned at least 14 days in advance.
(2) provide for substitutes of similar nutritive value
for patients who refuse food that is served, and
(3) be posted weekly for patient's review.
(g) Food must be prepared to conserve its nutritive value
and appearance.
(h) Food shall be served at the a ppropriate temperature, in
10:2
NORTH CAROLINA REGISTER
April 17, 1995
104
PROPOSED RULES
the form to meet the patient's individual needs and with
assistive devices as dictated by the patient's needs. The
following temperatures are acceptable upon patient receipt:
(1) Hot liquids 150 degrees (minimum)
(2) Hot cereal 150 degrees (minimum)
(3) Soups 130 degrees (minimum)
(4) Hot foods 110 degrees (minimum)
(5) Cold liquids 50 degrees (maximum)
(6) Cold foods 65 degrees (maximum)
(i) If patients require assistance in eating, food shall be
maintained at serving temperature until assistance is pro-
vided.
(i) All diets, including enteral and parenteral nutrition
therapy, shall be ordered by the physician and served as
ordered.
(k) At least three meals shall be served daily to all
patients in accordance with physician orders.
(1) No more than 14 hours shall elapse between an
evening meal containing a protein food and a morning meal
containing a protein food.
(m) Hour-of-sleep (hs) nourishment shall be available to
patients upon request or in accordance with nutritional
plans.
(n) Between meal fluids for hydration shall be available
and offered to all patients in accordance with physician
orders.
(o) The facility shall have a current nutrition care manual
or handbook a pproved by the dietitian, medical staff and the
Administrator which shall be used in the planning of the
regular and therapeutic diets and be accessible to all staff.
(p) Food services shall comply with Rules Governing the
Sanitation of Restaurants and Other Foodhandling Establish-
ments as promulgated by the Commission for Health
Services which is incorporated by reference, including
subsequent amendments, assuring storage, preparation, and
serving of food under sanitary conditions. Copies of these
Rules can be obtained, at no charge. by_ contacting the N.C.
Department of Environment. Health, and Natural Resources.
Division of Environmental Health. 1330 St. Mary's Street.
Raleigh. NC 27605-3248.
Statutory Authority G.S. 13 IE- 104.
SECTION .2800 - ACTIVITIES, RECREATION
AND SOCIAL SERVICES
.2801 ACTIVITY SERVICES
(a) The facility shall provide a program of activities that
is on-going and in accordance with the comprehensive
assessment, and that promotes the interests, as well as
physical, mental and psychosocial well-being, of each
patient.
(b) The administrator shall designate an activities director
who shall be responsible for activity and recreational
services for all patients and who shall have a ppropriate
management authority. The director shall:
(1) be a recreation therapist or be eligible for certifi-
cation as a therapeutic recreation specialist by a
recognized accrediting body; or
(2) have two years of experience in a social or
recreation program within the last five years,
one of which was full-time in a patient activities
program in a health care setting; or
(3) be an occupational therapist or occupational
therapy assistant; or
(4) be certified by the National Certification Council
for Activity Professionals; or
(5) have completed an activities training course
a pproved by the State.
Authority G. S.
483. 15tf).
131E-104; 143B-165(10); 42 C.F.R.
.2802 SOCIAL SERVICES
(a) The facility shall provide medically-related social
services to attain or maintain the highest practicable physi-
cal, mental and psychosocial well-being of each resident.
(b) The administrator shall designate an employee to be
responsible full-time for social services.
(c) A facility with more than 120 nursing beds shall
employ on a full time basis, a social worker who has:
(1) a Bachelors' degree in social work or a Bache-
lors' degree in human services field, including
but not limited to sociology special education,
rehabilitation counseling and psychology; and
(2) one year of supervised social work experience in
a health care setting working directly with
patients.
Statutory Authority G.S. 131E-104.
SECTION .2900 - SPECIAL REQUIREMENTS
.2901 REPORT OF DEATH
The facility shall have a written plan to be followed in
case of patient death. The plan shall provide for the
following:
(1) collection of data needed for the death certificate
as required by G.S. 130A-117;
(2) recording time of death;
(3) pronouncement of death in accordance with facil-
ity policy;
(4) notification of the attending physician responsible
for signing the death certificate;
(5) documented notification of next of kin or legal
guardian;
(6) authorization and release of the body to a funeral
home.
Statutory Authority G.S. 131E-104.
.2902 PETS (COMPANION ANIMALS)
When facility policies permit pets in the facility, the
following conditions shall be met:
(1) The facility policy shall not be in violation of any
local health ordinances regarding pet health and
705
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
control.
(2) Pets shall not be permitted to enter areas where
food is being prepared.
Statutory Authority G.S. 13 IE- 104.
SECTION .3000 - SPECIALLY DESIGNATED
UNITS
.3001 SPECIALIZED REHABmiTATIVE AND
HABn.ITATIVE SERVICES
Specialized rehabilitative and habilitative services, such as
physical therapy, occupational therapy and speech therapy,
are not required as a condition of licensure. Patients
requiring such services, however, shall not be admitted or
retained in a facility unless the facility is capable of furnish-
ing the needed services. If specialized rehabilitative
services are provided:
(1) The facility shall provide or obtain from an out-
side resource specialized rehabilitative services as
required by the patient's comprehensive plan of
care.
(2) Specialized rehabilitative services shall be ordered
by the physician and provided by a licensed or
certified, professional therapist in the area of
assignment.
Statutory Authority G.S. 131E-104.
.3002 QUALITY OF SPECIALIZED
REHABILITATION SERVICES
£a) While the person supervising specialized rehabilitative
and habilitative services shall be a licensed or certified
professional therapist, all other su pport personnel shall be
trained in the area of assignment and directly supervised by
the therapist in the area of assignment.
(b) Services provided through outside resources shall be
carried out through, and in accordance with, written
agreements.
(c) Services shall be designed to maintain and improve
the patient's ability to function independently, prevent as
much as possible the advancement of progressive disabili-
ties, and restore maximum function.
(d) If nursing staff carry out selected therapy procedures,
they shall do so under the supervision of the physical or
occupational therapist and only after documented training
and a pproval by the therapist. This is not to prohibit simple
restorative measures by the nursing staff.
Statutory Authority G.S. 13 IE- 104.
.3003 VENTH.ATOR DEPENDENCE
The general requirements in this Subchapter shall apply
when applicable. In addition, facilities having patients
requiring the use of ventilators for more than eight hours a
day shall meet the following requirements:
(1) The facility shall be located within 30 minutes of
(a)
lb)
[c]
an acute care facility.
(2) Respiratory therapy shall be provided and super-
vised by a respiratory therapist currently regis-
tered by the National Board for Respiratory Care.
The respiratory therapist shall:
make, as a minimum, weekly on-site assess-
ments of each patient receiving ventilator sup-
port with corresponding progress notes;
be on-call 24 hours daily; and
assist the pulmonologist and nursing staff in
establishing ventilator policies and procedures,
including emergency policies and procedures.
(3) Direct nursing care staffing shall be in accordance
with Rule .3005 of this Section.
Statutory Authority G.S. 131E-104.
.3004 BRAIN INJURY LONG-TERM CARE
(a) The general requirements in this Subchapter shall
apply when a pplicable, but brain injury long term care units
shall meet the supplement requirements in Rules .3004 and
.3005 of this Section. The facility shall provide services
through a medically supervised interdisciplinary process as
provided in Rule .2505 of this Subchapter and are directed
toward maintaining the individual at the optimal level of
physical, cognitive and behavioral functioning. Following
are the minimum requirements for specific services that may
be necessary to maintain the individual at optimum level:
Qj Overall supervisory responsibility for brain
injury long term care services shall be assigned
to a registered nurse with one year experience in
caring for brain injured patients.
(2) Physical therapy shall be provided by a physical
therapist with a current valid North Carolina
license. Occupational therapy shall be provided
by an occupational therapist with a current valid
North Carolina License. The services of a
physical therapist and occupational therapist shall
be combined to provide one full-time equivalent
position for each 20 patients. The assistance of
a physical therapy aide and occupational therapy
aide, with appropriate supervision, shall be
combined to provide one full-time equivalent
position for each 20 patients. A proportionate
number of hours shall be provided for a census
less than 20 patients.
(3) Clinical nutrition services shall be provided by
a qualified dietitian with two years clinical
training and experience in nutrition. The num-
ber of hours of clinical nutrition services on
either a full-time or part-time employment or
contract basis shall be adequate to meet the
needs of the patients. Each patient's nutrition
needs shall be reviewed at least monthly. Clini-
cal nutrition services shall include:
(A) Assessing the appropriateness of the ordered
diet for conformance with each patient's phvsi-
10:2
NORTH CAROLINA REGISTER
April 17, 1995
106
PROPOSED RULES
ological and pharmacological condition.
(B) Evaluating each patient's laboratory data in
relation to nutritional status and hydration.
(C) A pplying technical knowledge of feeding
tubes, pumps and equipment to each patient's
specialized needs.
£4} Clinical social work shall be provided by a
social worker meeting the requirements of Rule
.3002 of this Section.
(5) Recreation therapy, when required, shall be
provided on either a full-time or part-time
employment or contract basis by a clinician
eligible for certification as a therapeutic recre-
ation specialist by the State of North Carolina
Therapeutic Recreational Certification Board.
The number of hours of therapeutic recreation
services shall be adequate to meet the needs of
the patients. In event that a qualified specialist
is not locally available, alternate treatment
modalities shall be developed by the occupa-
tional therapist and reviewed by the attending
physician. The program designed shall be
adequate to meet the needs of this specialized
population and shall be administered in accor-
dance with Section .3000 of this Subchapter.
(6) Speech therapy, when required, shall be pro-
vided by a clinician with a current valid license
in speech pathology issued by the State Board of
Audiology and Speech Pathology.
(7) Respiratory therapy, when required, shall be
provided by an individual meeting the same
qualifications for providing respiratory therapy
under Rule .3003 of this Section.
(b) Each patient's program shall be governed by an
interdisciplinary treatment plan incorporating and expanding
upon the health plan required under Section .2300 of this
Subchapter. The plan is to be initiated on the first day of
admission. Upon completion of baseline data development
and an integrated interdisciplinary assessment, the initial
treatment plan is to be expanded and finalized within 14
days of admission. Through an interdisciplinary process the
treatment plan shall be reviewed at least monthly and
revised as appropriate. In executing the treatment plan, the
interdisciplinary team shall be the major decision making
body and shall determine the goals, process, and time
frames for accomplishment of each patient's program-
Disciplines to be represented on the team shall be medicine,
nursing, clinical pharmacy and all other disciplines directly
involved in the patient's treatment or treatment plan.
(c) Each patient's overall program shall be assigned to an
individually designated case manager. The case manager
acts as the coordinator for assigned patients. Any profes-
sional staff member involved in a patient's care may be
assigned this responsibility for one or more patients.
Professional staff may divide this responsibility for all
patients on the unit in the best manner to meet all patients'
needs for a coordinated, interdisciplinary approach to care.
This case manager shall be responsible for:
(1) coordinating the development, implementation
and periodic review of the patient's treatment
plan;
(2) preparing a monthly summary of the patient's
progress;
(3) cultivating the patient's participation in the
program;
(4) general supervision of the patient during the
course of treatment;
(5") evaluating appropriateness of the treatment plan
in relation to the attainment of stated goals; and
(6) assuring that discharge decisions and arrange-
ments for post discharge follow-up are properly
made.
(d) For each 20 patients or fraction thereof, dedicated
treatment facilities and equipment shall be provided as
follows:
(1) a combined therapy space equal to or exceeding
600 square feet, adequately equipped and ar-
ranged to su pport each of the therapies;
(2) access to one full reclining wheel chair per
patient;
(3) special physical therapy and occupational therapy
equipment for use in fabricating positioning
devices for beds and wheelchairs including
splints, casts, cushions, wedges, and bolsters;
and
(4) roll-in bath facilities with a dressing area avail-
able to all patients, providing maximum privacy
to the patient.
Statutory Authority G.S. 13 IE- 104.
.3005 SPECIAL NURSING REQUIREMENTS FOR
BRAIN INJURY LONG-TERM CARE
Direct care nursing personnel staffing ratios established in
Rule .2303 of this Subchapter shall not be a pplied to nursing
services for patients who require brain injury long-term
care. The minimum direct care nursing staff shall be 5.5
hours per patient day, allocated on a per shift basis as the
facility chooses, to appropriately meet the patients' needs.
It is also required that regardless of how low the patient
census, the direct care nursing staff shall not fall below a
registered nurse and a nurse aide I at any time during a
24-hour period.
Statutory Authority G.S. 13 IE- 104.
.3006 RESERVED FOR FUTURE CODIFICATION
.3007 RESERVED FOR FUTURE CODD7ICATION
.3008 RESERVED FOR FUTURE CODD7ICATION
.3009 RESERVED FOR FUTURE CODD7ICATION
.3010 RESERVED FOR FUTURE CODD7ICATION
107
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
.3011 HTV DESIGNATED UNIT POLICES AND
PROCEDURES
(a) In units dedicated to the treatment of patients with
Human Immunodeficiency Virus disease, policies and
procedures specific to the specialized needs of the patients
served shall be developed. At a minimum they shall include
staff training and education, and the availability of consulta-
tion by a physician with specialized education or knowledge
in the management of Human Immunodeficiency Virus
disease.
(b) Policies and procedures for infection control shall be
in conformance with 29 CFR 1910 (Occupational Safety and
Health Standards) which is incorporated by reference
including subsequent amendments. Emphasis shall be
placed on compliance with 29 CFR 1910-1030 (Bloodborne
Pathogens). Copies of Title 29 Part 1910 may be purchased
from the Superintendent of Documents. U.S. Government
Printing Office. Washington. D.C. 20402 for thirty eight
dollars ($38.00) or may be purchased with a credit card by
telephoning the Government Printing Office at (202)
783-3238. Infection control shall also be in compliance with
the Center of Disease Control Guidelines as published by
the U.S. Department of Health and Human Services. Public
Health Service, which is incorporated by reference, includ-
ing subsequent amendments. Copies may be purchased
from the National Technical Information Service. U.S.
Department of Commerce. 5285 Port Royal Road. Spring-
field. Virginia 22161 for fifteen dollars and ninety five cents
($15.95).
Statutory Authority G.S. 131E-104.
.3012 PHYSICIAN SERVICES IN AN HTV
DESIGNATED UNIT
In a facility with a Human Immunodeficiency Virus
designated unit, the facility shall ensure that attending
physicians have documented, prearranged access in person
or b_Y telephone to a physician with specialized education or
knowledge in the management of Human Immunodeficiency
Virus disease.
Statutory Authority G.S. 131E-104.
.3013 SPECIAL NURSING REQWREMENTS FOR
AN HTV DESIGNATED UNIT
(a) A facility with a Human Immunodeficiency Virus
designated unit shall have a registered nurse with specialized
education or knowledge in the care of Human Immunodefi-
ciency Virus disease.
(b) Nursing personnel assigned to the Human Immunode-
ficiency Virus unit shall be regularly assigned to the unit-
Periodic rotations are acceptable.
A facility with a Human Immunodeficiency Virus de sig-
nated unit shall provide an organized, documented program
of education specific to the care of patients infected with the
Human Immunodeficiency Virus, including at a minimum:
(1) Human Immunodeficiency Virus and Acquired
Immune Deficiency Syndrome disease processes;
transmission modes, causes, and prevention of
Human Immunodeficiency Virus;
treatment of Human Immunodeficiency Virus and
Acquired Immune Deficiency Syndrome;
psycho-socio-economic needs of the Human
Immunodeficiency Virus and Acquired Immune
Deficiency Syndrome patients;
universal precautions and infection control; and
policies and procedures specific to the Human
Immunodeficiency Virus designated unit.
£21
£3}
£4}
£5}
£6}
Statutory Authority G.S. 13 IE- 104.
.3015 USE OF INVESTIGATIONAL DRUGS FOR
HTV DESIGNATED UNITS
(a) The supervision and monitoring for the administration
of investigational drugs is the responsibility of the pharma-
cist and a registered nurse, acting pursuant to the orders of
a physician authorized to prescribe or dispense such drugs.
Responsibilities shall include, but not be limited to. the
following:
(1) insuring the provision of written guidelines for
any investigational drug or study; and
(2) training and determination of staffs abilities
regarding administration of drugs, policies,
procedures and regulations.
(b) The pharmacist or physician dispensing the investiga-
tional drug is to provide the facility with information
regarding at least the following:
(1) a copy of the protocol, including drug informa-
tion;
(2) a copy of the patient's informed consent;
(3) drug storage;
(4) handling;
(5) any specific preparation and administration
instructions;
(6) specific details for drug accountability, resupply
and return of unused drug; and
(7) a copy of the signed consent to participate in the
study.
(c) Labeling of investigational drugs shall be in accor-
dance with written guidelines of protocol and State and
federal requirements regarding such drugs. Prescription
labels for investigational drugs are to be distinguishable
from other labels by an a ppropriate legend. "Investigational
Drug" or "For Investigational Use Only."
Statutory Authority G.S. 131E-104.
Statutory Authority G.S. 131E-104.
.3014 SPECIALIZED STAFF EDUCATION FOR HTV
DESIGNATED UNITS
.3016 ADDITIONAL SOCIAL WORK
REQUIREMENTS FOR HTV DESIGNATED
10:2
NORTH CAROLINA REGISTER
April 17, 1995
108
PROPOSED RULES
UNITS
In addition to the social work services specified in Rule
.3002 of this Section, in a facility with a Human Immunode-
ficiency Virus disease designated unit, the social worker
shall provide or arrange for the provision of spiritual,
pastoral and grief counseling and bereavement services for
patients and staff where appropriate. Su pport services shall
be provided to the patients' families and significant others.
Where necessary, coordination with treatment services for
substance abuse, legal services and other community
resources shall be identified.
Statutory Authority G.S. 13 IE- 104.
.3017 RESERVED FOR FUTURE CODIFICATION
.3018 RESERVED FOR FUTURE CODDJICATION
.3019 RESERVED FOR FUTURE CODIFICATION
.3020 RESERVED FOR FUTURE CODIFICATION
.3021 PHYSICIAN REQWREMENTS FOR
INPATIENT REHABILITATION
FACILnTES OR UNITS
(a] In a rehabilitation facility or unit a physician shall
participate in die provision and management of rehabilitation
services and in the provision of medical services.
£b) In a rehabilitation facility or unit a rehabilitation
physician shall be responsible for a patient's interdisciplin-
ary treatment plan. Each patient's interdisciplinary treat-
ment plan shall be developed and implemented under the
supervision of a rehabilitation physician.
(c) The rehabilitation physician shall participate in the
preliminary assessment within 48 hours of admission,
prepare a plan of care and direct the necessary frequency of
contact based on the medical and rehabilitation needs of the
patient. The frequency shall be appropriate to justify the
need for comprehensive inpatient rehabilitation care.
(d) An inpatient rehabilitation facility or unit's contract or
agreements with a rehabilitation physician shall require that
the rehabilitation physician shall participate in individual
case conferences or care planning sessions and shall review
and sign discharge summaries and records. When patients
are to be discharged to another health care facility, the
discharging facility shall ensure that the patient has been
provided with a discharge plan which incorporates post
discharge continuity of care and services. When patients are
to be discharged to a residential setting, the facility shall
ensure that the patient has been provided with a discharge
plan that incorporates the utilization of community resources
when available and when included in the patient's plan of
care.
(e) The intensity of physician medical services and the
frequency of regular contacts for medical care for the
patient shall be determined by the patieni's pathophysiologic
needs.
(f) Where the attending physician of a patient in an
inpatient rehabilitation facility or unit orders medical
consultations for the patient, such consultations shall be
provided by qualified physicians within 48 hours of the
physician's order. In order to achieve this result, the
contracts or agreements between inpatient rehabilitation
facilities or units and medical consultants shall require that
such consultants render the requested medical consultation
within 48 hours.
(g) An inpatient rehabilitation facility or unit shall have
a written procedure for setting the qualifications of the
physicians rendering physical rehabilitation services in the
facility or unit.
Statutory Authority G.S. 13 IE- 104.
.3022 ADMISSION CRITERIA FOR INPATDZNT
REHABILITATION FACILITIES OR UNITS
(a) The facility shall have written criteria for admission
to the inpatient rehabilitation facility or unit. A description
of programs or services for screening the suitability of a
given patient for placement shall be available to staff and
referral sources.
fb) For patients found unsuitable for admission to the
inpatient rehabilitation facility or unit, there shall be
documentation of the reasons.
(c) Within 48 hours of admission a preliminary assess-
ment shall be completed by members of the interdisciplinary
team to ensure the a ppropriateness of placement and to
identify the immediate needs of the patient.
(d) Patients admitted to an inpatient rehabilitation facility
or unit must be able to tolerate a minimum of three hours of
rehabilitation therapy, five days a week, including at least
two of the following rehabilitation services: physical
therapy, occupational therapy or speech therapy.
(e) Patients admitted to an inpatient rehabilitation facility
or unit must be medically stable, have a prognosis indicating
a progressively improved medical condition and have the
potential for increased independence.
Statutory Authority G.S. 13 IE- 104.
.3023 COMPREHENSIVE INPATIENT
REHABILITATION EVALUATION
(a) A comprehensive, inpatient rehabilitation evaluation
is required for each patient admitted to an inpatient rehabili-
tation facility or unit. At a minimum this evaluation shall
include the reason for referral, a summary of the patient's
clinical condition, functional strengths and limitations, and
indications for specific services. This evaluation shall be
completed within three days.
(b) Each patient shall be evaluated by the interdisciplinary
team to determine the need for any of the following ser-
vices: medical, dietary, occupational therapy, physical
therapy, prosthetics and orthotics, psychological assessment
and therapy, therapeutic recreation, rehabilitation medicine,
rehabilitation nursing, therapeutic counseling or social work,
vocational rehabilitation evaluation and speech-language
pathology.
109
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
Statutory Authority G.S. 13 IE- 104.
.3024 COMPREHENSIVE INPATIENT
REHABILITATION INTERDISCIPLINARY
TREAT/PLAN
(a) The interdisciplinary treatment team shall develop an
individual treatment plan for each patient within seven days
after admission. The plan shall include evaluation findings
and information about the following:
(1) prior level of function;
(21 current functional limitations:
(3) specific service needs:
(4) treatment, su pports and adaptations to be pro-
vided:
(5) specified treatment goals;
(6) disciplines responsible for implementation of
separate parts of the plan; and
£7} anticipated time frames for the accomplishment
of specified long-term and short-term goals.
Co) The treatment plan shall be reviewed by the interdisci-
plinary team at least every other week. All members of the
interdisciplinary team, or a representative of their discipline,
shall attend each meeting. Documentation of each review
shall include progress toward defined goals and identifica-
tion of any changes in the treatment plan.
(c) The treatment plan shall include provisions for all of
the services identified as needed for the patient in the
comprehensive inpatient rehabilitation evaluation completed
in accordance with Rule .3023 of this Section-
al Each patient shall have a designated case manager
who is responsible for the coordination of the patient's
individualized treatment plan. The case manager is respon-
sible for promoting the program's responsiveness to the
needs of the patient and shall participate in all team confer-
ences concerning the patient's progress toward the accom-
plishment of specified goals. Any of the professional staff
involved in the patient's care may be the designated case
manager for one or more cases, or the director of nursing
or social worker may accept the coordination responsibility
for the patients.
Statutory Authority G.S. 131E-104.
.3025 DISCHARGE CRITERIA FOR INPATIENT
REHABILITATION FACILITDZS OR UNITS
(a) Discharge planning shall be an integral part of the
patient's treatment plan and shall begin upon admission to
the facility. After established goals have been reached, or
a determination has been made that care in a less intensive
setting would be a ppropriate, or that further progress is
unlikely, the patient shall be discharged to an appropriate
setting. Other reasons for discharge may include an
inability or unwillingness of patient or family to cooperate
with the planned therapeutic program or medical complica-
tions that preclude a further intensive rehabilitative effort.
The facility shall involve the patient, family, staff members
and referral sources in discharge planning.
(b) The case manager shall facilitate the discharge or
transfer process in coordination with the facility social
worker.
(c) If a patient is being referred to another facility for
further care, a ppropriate documentation of the patient's
current status shall be forwarded with the patient. A formal
discharge summary shall be forwarded within 48 hours
following discharge and shall include the reasons for
referral, the diagnosis, functional limitations, services
provided, the results of services, referral action recommen-
dations and activities and procedures used by the patient to
maintain and improve functioning.
Statutory Authority G.S. 131-104.
.3026 COMPREHENSIVE REHABILITATION
PERSONNEL ADMINISTRATION
(a) The facility shall have qualified staff members,
consultants and contract personnel to provide services to the
patients admitted to the inpatient rehabilitation facility or
unit.
Co) Personnel shall be employed or provided by contrac-
tual agreement in sufficient types and numbers to meet the
needs of all patients admitted for comprehensive rehabilita-
tion.
(c) Written agreement shall be maintained by the facility
when services are provided by contract on an ongoing basis.
Statutory Authority G.S. 131E-104.
.3027 COMPREHENSIVE INPATIENT
REHABILITATION PROGRAM
STAFFING REQUIREMENTS
(a) The staff of the inpatient rehabilitation facility or unit
shall include at a minimum:
(1) The inpatient rehabilitation facility or unit shall
be supervised by a rehabilitation nurse. The
facility shall identify the nursing skills necessary
to meet the needs of the rehabilitation patients in
the unit and a ssign staff qualified to meet those
needs.
(2) The minimum nursing hours per patient in the
rehabilitation unit shall be 5.5 nursing hours per
patient day. At no time shall direct care nursing
staff be less than two full-time equivalents, one
of which shall be a registered nurse.
(3} The inpatient rehabilitation unit shall employ or
provide by contractual agreements sufficient
therapists to provide a minimum of three hours
of specific (physical . occupational or speech) or
combined rehabilitation therapy services per
patient day.
(4) Physical therapy assistants and occupational
therapy assistants shall be supervised on-site by
physical therapists or occupational therapists.
(5) Rehabilitation aides shall have documented
training appropriate to the activities to be per-
10:2
NORTH CAROLINA REGISTER
April 17, 1995
110
PROPOSED RULES
formed and the occupational licensure laws of
his or her supervisor. The overall responsibility
for the on going supervision and evaluation of
the rehabilitation aide remains with the regis-
tered nurse as identified in Subparagraph (aid)
of this Rule. Supervision by the physical thera-
pist or by the occupational therapist is limited to
that time when the therapist is on-site and direct-
ing the rehabilitation activities of the aide.
(6) Hours of service by the rehabilitation aide are
counted toward the required nursing hours when
the aide is working under the supervision of the
nurse. Hours of service by the rehabilitation
aide are counted toward therapy hours during
that time the aide works under the immediate,
on-site supervision of the physical therapist or
occupational therapist. Hours of service shall
not be dually counted for both services. Hours
of service by rehabilitation aides in performing
nurse-aide duties in areas of the facility other
than the rehabilitation unit shall not be counted
toward the 5.5 hour minimum nursing require-
ment described for the rehabilitation unit,
(b) Additional personnel shall be provided as required to
meet the needs of the patient, as defined in the comprehen-
sive inpatient rehabilitation evaluation.
Statutory Authority G.S. 13 IE- 104.
.3028 STAFF TRAINING FOR INPATIENT
REHABILITATION FACILITIES OR
UNIT
Prior to the provision of care, all rehabilitation personnel,
excluding physicians, assigned to the rehabilitation unit shall
be provided training or shall provide documentation of
training that includes at a minimum the following:
(1) active and passive range of motion;
assistance with ambulation;
transfers;
m
£2}
£4}
(5)
m
m
m
m
(10)
OD
(12)
maximizing functional independence;
the psycho-social needs of the rehabilitation
patient;
the increased safety risks of rehabilitation training
including falls and the use of restraints;
proper body mechanics;
nutrition, including dysphagia and restorative
eating;
communication with the aphasic and hearing
impaired patient;
behavior modification:
bowel and bladder training; and
skin care.
Statutory Authority G.S. 131E-104.
.3029 EQUIPMENT REQS/COMPREHENSIVE
INPATIENT REHABILITATION
PROGRAMS
(a) The facility shall provide each discipline with the
necessary equipment and treatment methods to achieve the
short and long-term goals specified in the comprehensive
inpatient rehabilitation interdisciplinary treatment plans for
patients admitted to these facilities or units.
(b) Each patient's needs for a standard wheelchair or a
specially designed wheelchair or additional devices to allow
safe and independent mobility within the facility shall be
met.
(c) Special physical therapy and occupational therapy
equipment for use in fabricating positioning devices for beds
and wheelchairs shall be provided, including splints, casts,
cushions, wedges and bolsters.
(d) Physical therapy devices shall be provided, including
a mat table, parallel bars, sliding boards and special
adaptive bathroom equipment.
Statutory Authority G.S. 13 IE- 104.
.3030 PHYSICAL FACILITY REQS/INPATIENT
REHABILITATION FACILITIES OR UNIT
(a) The inpatient rehabilitation facility or unit shall be in
a designated area and shall be used for the specific purpose
of providing a comprehensive inpatient rehabilitation
program.
(b) The floor area of a single bedroom shall be sufficient
for the patient or the staff to easily transfer the patient from
the bed to a wheelchair and to maneuver a 180 degree turn
with a wheelchair on at least one side of the bed.
(c) The floor area of a multi-bed bedroom shall be
sufficient for the patient or the staff to easily transfer the
patient from the bed to a wheelchair and to maneuver a 180
degree turn with a wheelchair between beds.
(d) Each patient room shall meet the following require-
ments:
(1) Maximum room capacity of no more than four
patients;
(2) Operable windows:
(3) A nurse call system designed to meet the special
needs of rehabilitation patients:
(4) In single and two-bed rooms with private toilet
room, the lavatory may be located in the toilet
room;
(5) A wardrobe or closet for each patient which is
wheelchair accessible and arranged to allow the
patient to access the contents;
(6) A chest of drawers or built-in drawer storage
with mirror above, which is wheelchair accessi-
ble; and
(7") A bedside table for toilet articles and personal
belongings.
(e) Space for emergency equipment such as resuscitation
carts shall be provided and shall be under direct control of
the nursing staff, in proximity to the nurse's station and out
of traffic.
(f) Patients' bathing facilities shall meet the following
specifications:
(1) There shall be at least one shower stall or one
111
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
bathtub for each 15 beds not individually served.
Each tub or shower shall be in an individual
room or privacy enclosure which provides space
for the private use of the bathing fixture, for
drying and dressing and for a wheelchair and an
assisting attendant.
(2) Showers in central bathing facilities shall be at
least five feet square without curbs and designed
to permit use by a wheelchair patient.
(3) At least one five-foot-bv-seven-foot shower shall
be provided which can accommodate a stretcher
and an assisting attendant.
(g) Patients' toilet rooms and lavatories shall meet the
following specifications:
(1) The size of toilet rooms shall permit a wheel-
chair, a staff person and appropriate
wheel-to-water closet transfers.
(2) A lavatory in the room shall permit wheelchair
access.
(3) Lavatories serving patients shall:
(A) allow wheelchairs to extend under the lavatory;
and
(B) have water supply spout mounted so that its
discharge point is a minimum of five inches
above the rim of the fixture.
(4) Lavatories used by patients and by staff shall be
equipp ed with blade-operated supply valves.
(h) The space provided for physical therapy, occupational
therapy and speech therapy by all inpatient rehabilitation
facilities or units may be shared but shall, at a minimum,
include:
(1) office space for staff:
(2) office space for speech therapy evaluation and
treatment:
(3) waiting space:
(4) training bathroom which includes toilet, lavatory
and bathtub:
gymnasium or exercise area:
work area such as tables or counters suitable for
wheelchair access:
treatment areas with available privacy curtains
or screens:
£51
£61
£21
£S1
an activities of daily living training kitchen with
sink, cooking top (secured when not supervised
by staff), refrigerator and counter surface for
meal preparation:
£21 storage for clean linens, supplies and equipment:
(10) janitor's closet accessible to the therapy area
with floor receptor or service sink and storage
space for housekeeping su pplies and equipment,
with one closet or space serving more than one
area of the inpatient rehabilitation facility or unit
as needed: and
(11) hand washing facilities.
£il For social work and psychological services the
following shall be provided:
(1) office space for staff:
(2) office space for private interviewing and coun-
seling for all family members: and
(3) work space for testing, evaluation and counsel-
ing.
(jl If prosthetics and orthotics services are provided, the
following space shall be made available as necessary:
(1) work space for technician; and
£21 space for evaluation and fittings (with provisions
for privacy!.
(k) If vocational therapy services are provided, the
following space shall be made available as necessary:
office space for staff;
work space for vocational services activities such
as prevocational and vocational evaluation:
training space;
storage for equipment; and
counseling and placement space.
(1) Recreational therapy space requirements include the
following:
activities space:
storage for equipment and su pplies;
office space for staff; and
access to male and female toilets.
(m) The following space shall be provided for patient
dining, recreation and day areas:
01
121
£21
£41
£51
01
£21
£21
£41
(1) sufficient room for wheelchair movement and
wheelchair dining seating;
£21 if food service is cafeteria type, adequate width
for wheelchair maneuvers, queue space within
the dining area (and not in a corridor) and a
serving counter low enough to view food;
£3_1 total space for inpatients, a minimum of 25
square feet per bed;
£41 for outpatients participating in a day program or
partial day program. 20 square feet when dining
is a part of the program and 10 square feet when
dining is not a part of the program; and
(5) storage for recreational equipment and supplies,
tables and chairs,
(n) The patient dining, recreation and day area spaces
shall be provided with windows that have glazing of an area
not less than eight percent of the floor area of the space,
and at least one-half of the required window area must be
operable.
(0) A laundry shall be available and accessible for
patients.
Statutory Authority G.S. 13 IE- 104.
.3031 ADDITIONAL REQUIREMENTS FOR
SPINAL CORD INJURY PATENTS
Inpatient rehabilitation facilities providing services to
persons with spinal cord injuries shall meet the requirements
in this Rule in addition to those identified in this Section.
(1) Direct-care nursing personnel staffing ratios
established in Rule .3027 of this Section shall not
be a pplied to nursing services for spinal cord
10:2
NORTH CAROLINA REGISTER
April 17, 1995
112
PROPOSED RULES
injury patients in the inpatient rehabilitation
facility or unit. The minimum nursing hours per
spinal cord injury patient in the unit shall be 6.0
nursing hours per patient day. At no time shall
direct care nursing staff be less than two full-time
equivalents, one of which shall be a registered
nurse.
(2) The inpatient rehabilitation facility or unit shall
employ or provide by contractual agreements
physical, occupational or speech therapists in
order to provide a minimum of 4J) hours of
specific or combined rehabilitation therapy ser-
vices per spinal cord injury patient day.
(3) The facility shall provide special facility or special
equipment needs of patients with spinal cord
injury, including specially designed wheelchairs,
tilt tables and standing tables.
(4) The medical director of an inpatient spinal cord
injury program shall have either two years experi-
ence in the medical care of persons with spinal
cord injuries or six months minimum in a spinal
cord injury fellowship.
(5) The facility shall provide continuing education in
the care and treatment of spinal cord injury pa-
tients for all staff.
(6) The facility shall provide specific staff training
and education in the care and treatment of spinal
cord injury.
(7) The size of the spinal cord injury program shall be
adequate to support a comprehensive, dedicated
ongoing spinal cord injury program.
Statutory Authority G.S. 13 IE- 104.
.3032 DEEMED STATUS FOR INPATIENT
REHABILITATION FACILITIES OR
UNITS
(a) If an inpatient rehabilitation facility or unit with a
comprehensive inpatient rehabilitation program is surveyed
and accredited by the Joint Commission for the Accredita-
tion of Health Care Organizations (JCAHO) or the Commis-
sion on Accreditation of Rehabilitation Facilities (CAR! 7 ),
and has been a pproved by the Department in accordance
with G.S. 13 IE. Article 9^ the Department deems the
facility to be in compliance with Rules .3021 through .3031
of this Section.
(b) Deemed status shall be provided only if the inpatient
rehabilitation facility or unit provides copies of survey
reports to the Department. The JCAHO report shall show-
that the facility or unit was surveyed for rehabilitation
services. The CARF report shall show that the facility or
unit was surveyed for comprehensive rehabilitation services.
The facility or unit shall sign an agreement (Memorandum
of Understanding) with the Department specifying these
terms.
£c) The inpatient rehabilitation facility or unit shall be
subject to inspections or complaint investigations by repre-
sentatives of the Department at any time. If the facility or
unit is found not to be in compliance with the rules listed in
Paragraph (a) of this Rule, the facility shall submit a plan of
correction and be subject to a follow-up visit to ensure
compliance.
(d) If the inpatient rehabilitation facility or unit loses or
does not renew its accreditation, the facility or unit shall
notify the Department in writing within 30 days.
Statutory Authority G.S. 13 IE- 104.
SECTION .3100 - DESIGN AND CONSTRUCTION
.3101 GENERAL RULES
(a) Each facility shall be planned, constructed, equipped,
and maintained to provide the services offered in the
facility.
(b) A new facility or remodeling of an existing facility
shall meet the requirements of the North Carolina State
Building Code, all a pplicable volumes, which is incorpo-
rated by reference, including all subsequent amendments.
Copies of this code may be purchased from the Department
of Insurance Engineering Division located at 410 North
Boylan Avenue. Raleigh. NC 27603 at a cost of two
hundred fifty dollars ($250.00). Existing licensed facilities
shall meet the requirements of the North Carolina State
Building Code in effect at the time of construction or
remodeling.
(c) Any existing building converted from another use to
a nursing facility shall meet all requirements of a new
facility.
(d) The sanitation, water su pply, sewage disposal and
dietary facilities shall comply with the rules of the Commis-
sion for Health Services, which are incorporated by refer-
ence, including all subsequent amendments. Copies of these
Rules may be obtained from the Department of Environ-
ment, Health, and Natural Resources, Division of Environ-
mental Health. Environmental Health Services Section, 512
N. Salisbury Street, Raleigh, NC 27604-1148 at no cost.
(e) The domiciliary portion of a combination facility shall
meet the rules for a nursing facility contained in Sections
.3100, .3200, .3300. and .3400 of this Subchapter, except
when separated by two-hour fire-resistive construction.
When separated by two hour fire resistive construction, the
domiciliary portion of the facility shall meet the rules for
domiciliary homes in H) NCAC 42D. Licensing of Homes
for the Aged and Infirm, which are incorporated by refer-
ence, including all subsequent amendments: and domiciliary
resident areas must be located in the domiciliary section of
the facility. Copies of JO NCAC 42D can be obtained free
of charge from the Division of Facility Services, Domicili-
ary and Group Care Section, P.O. Box 29530. Raleigh, NC
27626-0530.
(f) An addition to an existing facility shall meet the same
requirements as a new facility.
Authority G.S. 131E-104; 42 U.S.C. 1396.
.3102 APPLICATION OF PHYSICAL PLANT
113
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
REQUIREMENTS
The physical plant requirements for each facility shall be
applied as follows:
(1) New construction shall comply with the require-
ments of Sections .3100-.3400 of this Subchapter.
(2) Except where otherwise specified, existing build-
ings shall meet licensure and code requirements in
effect at the time of construction, alteration or
modification.
(3) New additions, alterations, modifications and
repairs shall meet the technical requirements of
Sections .3100-.3400 of this Subchapter; however,
where strict conformance with current require-
ments would be impractical, the authority having
jurisdiction may a pprove alternative measures
where the facility can demonstrate to the Divi-
sion's satisfaction that the alternative measures do
not reduce the safety or operating effectiveness of
the facility.
{4} Rules contained in Sections .3100-. 3400 of this
Subchapter are minimum requirements and are not
intended to prohibit buildings, systems or opera-
tional conditions that exceed minimum require-
ments.
(5) Equivalency: alternate methods, procedures,
design criteria and functional variations from the
physical plant requirements, because of extraordi-
nary circumstances, new programs or unusual
conditions, may be a pproved by the authority
having jurisdiction when the facility can effec-
tively demonstrate to the Division's satisfaction,
that the intent of the physical plant requirements
are met and that the variation does not reduce the
safety or operational effectiveness of the facility.
(6) Where rules, codes or standards have any conflict,
the most stringent requirement shall a pply.
Statutory Authority G.S. 131E-104.
.3103 SITE
The site of the proposed facility must be a pproved by the
Department prior to construction and shall:
(1) be accessible by public roads and public transpor-
tation:
(21 be accessible to fire fighting services:
(3) have an a pproved water su pply, sewage disposal
system, garbage disposal system and trash disposal
system:
(4) meet all local ordinances and zoning laws; and
(5) be free from exposure to hazards and pollutants.
Statutory Authority G.S. 131E-104.
.3104 PLANS AND SPECIFICATIONS
(a) When construction or remodeling is planned, final
working drawings and specifications shall be submitted by
the owner or his a ppointed representative to the Department
for review and approval. Schematic drawings and prelimi-
nary working drawings shall be submitted by the owner
prior to the required submission of final working drawings.
The Department will forward copies of each submittal to the
Department of Insurance and the Division of Environmental
Health for review and approval. Three copies of the plan
shall be provided at each submittal.
(b") A pproval of final plans and specifications must be
obtained from the Department prior to licensure. A pproval
of plans shall expire after one year unless a building permit
for the construction has been obtained prior to the expiration
date of the a pproval of final plans.
(c) If an a pproval expires, renewed approval shall be
issued provided revised plans meeting all current regula-
tions, codes, and standards are submitted and reviewed.
(d) Completed construction or remodeling shall conform
to the minimum standards established in Sections .3100.
.3200. .3300. and .3400 of this Subchapter. Prior to
a pproval for licensure, one set of "as built working draw-
ings" shall be furnished to the Department. Final working
drawings and building construction including building
systems operation must be a pproved by the Department
prior to licensure.
(e) The owner or his designated agent shall notify the
Department when actual construction or remodeling starts
and at points when construction is 50 percent. 75 percent,
and 90 percent complete and upon final completion. New
construction or remodeling must be a pproved in writing by
the Department prior to use.
Statutory Authority G.S. 13 IE- 104.
SECTION .3200 - FUNCTIONAL
REQUIREMENTS
.3201 REQUIRED SPACES
(a) The net floor area of a single bedroom shall not be
less than 100 square feet and the net floor area of a room
for more than one bed shall not be less than 80 square feet
per bed. The 80 square feet and 100 square feet require-
ments shall be exclusive of closets, toilet rooms, vestibules
or wardrobes. When a designated single room exceeds 159
net square feet in floor area, it shall remain a single
bedroom and cannot be used as a multi-bedroom at any
future date.
(b) The total space set aside for dining, recreation and
other common use shall not be less than 25 square feet per
bed for a nursing facility and 30 square feet per bed for the
domiciliary portion of a combination facility. Physical
therapy, occupational therapy and rehabilitation space shall
not be included in this total:
(1) In new facilities, included in the total square
footage required by Paragraph Co) of this Rule.
a separate dining area or areas at 10 square feet
per bed minimum: at least one separate activity
area at 5 square feet per bed minimum: and at
least one separate living area at 5 square feet per
10:2
NORTH CAROLINA REGISTER
April 17, 1995
114
PROPOSED RULES
bed minimum shall be provided.
(2) Dining, activity, and living areas shall be de-
signed and equipp ed to provide accessibility to
both patients confined to wheelchairs and ambu-
latory patients.
(3) Closets and storage units for equipment and
su pplies shall not be included as part of the
required dining, activity, and living floor space
area.
(4) Handicap accessible outdoor areas for individual
and group activities shall be provided.
(5) Separate bedroom closets or wardrobes shall be
provided in each bedroom to provide each
occupant with a minimum of 48 cubic feet of
lockable clothing space at least half of which is
for hanging clothes.
(c") A toilet room shall be directly accessible from each
patient room and from each central bathing area without
going through the general corridor. One toilet room may
serve two patient rooms but not more than eight beds. The
lavatory may be omitted from the toilet room if one is
provided in each patient room. One tub or shower shall be
provided for each 15 beds not individually served. There
shall be at least one bathtub accessible on three sides and
one shower provided for each 60 beds or fraction thereof.
(d) For each nursing unit, or fraction thereof on each
floor, the following shall be provided:
(1) a medication preparation area with a counter, a
sink with four-inch faucet trim handles, a medi-
cation refrigerator, eve level medication storage,
cabinet storage and double locked narcotic
storage room, located adjacent to the nursing
station or under visual control of the nursing
station;
(2) a clean utility room with counter, sink with
four-inch handles, wall and under counter stor-
age;
(3) a soiled utility room with counter, sink with
four-inch handles, wall and under counter stor-
age, a flush-rim clinical sink or water closet
with a device for cleaning bedpans and a means
for washing and sanitizing bedpans and other
utensils;
£4} a nurses' toilet and locker space for coats,
purses, and personal belongings;
(5) an audio-visual nurse-patient call system ar-
ranged to ensure that a patient's call in the
facility is noted at a staffed station;
(6) a soiled linen storage room;
(7) a clean linen storage room;
(8) a nourishment station in a separate area enclosed
with walls and doors which contains work space,
cabinets and refrigerated storage, and a small
stove, microwave oven or hot plate; and
(9) one nurses' station consisting of desk space for
writing, storage space for office su pplies, stor-
age space for patients' records and space for
nurses' call equipment.
(e) Clean linen storag e shall be provided in a separate
room from bulk supplies. Clean linen for nursing units may
be stored in closed carts or cabinets in the clean utility room
or in a linen closet on the unit floor.
(f) A soiled linen room shall be provided.
(g) Each nursing unit shall be provided with at least one
janitor's closet. The kitchen area and laundry area each
shall have a janitor's closet. Administration, occupational
and physical therapy, recreation, personal care and em-
ployee facilities shall be provided janitor's closets and may
share one as a group.
(h) Stretcher and wheelchair storage shall be provided.
(i) Bulk storage shall be provided at the rate of five
square feet of floor area per bed.
{j} Office space shall be provided for persons holding the
following positions: administrator, director of nursing,
social services director, activities director and physical
therapist. There shall also be a business office.
0c) Each new combination facility shall provide a mini-
mum of one residential washer and residential dryer located
to be accessible by_ domiciliary staff, residents, and family.
Statutory Authority G.S. 13 IE- 104.
.3202 FURNISHINGS
(a) Handgrips shall be provided for all toilet and bath
facilities used by patients. Handrails shall be provided on
both sides of all corridors used by patients.
(b) Flame resistant privacy screens or curtains shall be
provided in multi-bedded rooms.
Statutory Authority G.S. 13 IE- 104.
SECTION .3300 - FIRE AND SAFETY
REQUIREMENTS
.3301 NEW FACILITY REQUIREMENTS
In addition to the requirements in Rule .3101(b) of this
Subchapter, a new facility shall meet the following addi-
tional requirements:
(1) Each floor used for patient sleeping rooms shall be
divided into at least two sections by a smoke
partition.
(2) Nursing units shall be designed to provide separa-
tion from other departments or services with a
smoke barrier.
(3) Horizontal exits are not permitted in any new
facility.
Statutory Authority G.S. 13 IE- 104.
.3302 ADDITIONS
An addition to an existing facility shall meet the same
requirements as a new facility except that in no case shall
more than one horizontal exit be used to replace a required
exit to the outside.
Statutory Authority G.S. 131E-104.
i
115
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
SECTION .3400 - MECHANICAL: ELECTRICAL:
PLUMBING
.3401 HEATING AND AIR CONDITIONING
Heating and cooling systems shall meet the American
Society of Heating. Refrigeration, and Air Conditioning
Engineers Guide rwhich is incorporated by reference,
including all subsequent amendments: copies of this docu-
ment may be obtained from the American Society of
Heating. Refrigerating & Air Conditioning Engineers at
United Engineer Center. 345 East 47th Street. New York.
NY 10017 at a cost of one hundred nineteen dollars
($119.00.11: and the National Fire Protection Association
Code 90A. [current addition with all subsequent amend-
ments which is adopted by reference; copies of this code
may be obtained from the National Fire Protection Associa-
tion. I Battery march Park. P.O. Box 9101. Ouincv.MA
02269-9101 at a cost of nineteen dollars and fifty cents
($19.50)1 with the following modifications:
(1) Drug rooms must have positive pressure with
relationship to adjacent areas.
(2) Environmental temperature control systems shall
be capable of maintaining temperatures in the
facility at 72 degrees F. minimum in the heating
season and a maximum of 8J. degrees j\ during
the non-heating season.
(3) Rooms designated for isolation shall have negative
or positive pressure with relationship to adjacent
areas depending upon the type of patient to be
isolated. Exhaust for isolation rooms shall be
ducted directly to the outdoors.
Statutory Authority G.S. 131E-104.
.3402 EMERGENCY ELECTRICAL SERVICE
Emergency electrical service shall be provided for use in
the event of failure of the normal electrical service. This
emergency service shall consist of the following:
(1) In any existing facility, the following shall be
provided:
(a) type 1 or 2 emergency lights as required by the
North Carolina State Building Code:
(b) additional emergency lights for all nursing
stations, drug preparation and storage areas, and
for the telephone switchboard, if a pplicable:
(c) one or more portable battery-powered lamps at
each nursing station: and
(d) a suitable source of emergency power for
life-sustaining equipment, if the facility admits
or cares for occupants needing such equipment.
to ensure continuous operation for a minimum of
72 hours.
(2) Any new addition to an existing facility shall meet
the same requirements as new construction.
(3) Any conversion of an existing building (hotel,
motel, abandoned hospital, abandoned school, or
other building) shall meet the same requirements
for emergency electrical services as required for
new construction.
(4) For new construction, an emergency generating
set, including the prime mover and generator,
shall be located on the premises and shall be
reserved exclusively for supplying the emergency
electrical system.
(5) Emergency electrical services shall be provided
for new facilities as required by Rule .3101(b) of
this Subchapter with the following modifications:
(a) Exception No. 2 and Exception No. 3 contained
in Section 517-10 of the North Carolina State
Building Code. Volume IV shall not apply to
new facilities.
(b) Egress lighting shall be connected to the essen-
tial electrical system at exterior of exits.
(c) Task illumination in the switch gear and boiler
rooms shall be connected to the essential electri-
cal system.
(6) The following equipment, devices, and systems
which are essential to life, safety, and the protec-
tion of im portant equipment or vital materials shall
be connected to the emergency electrical system as
follows:
(a) nurses' calling system:
(b) fire pump if installed:
(c) sewerage lift or sump pumps if installed:
(d) one elevator, where elevators are used for
vertical transportation of patients:
(e) equipment such as burners and pumps necessary
for operation of one or more boilers and their
necessary auxiliaries and controls, required for
heating and sterilization, if installed:
(f) equipment necessary for maintaining telephone
service.
(7) A minimum of one dedicated emergency branch
circuit per bed for ventilator dependent patients is
required in addition to the normal system recepta-
cle at each bed location required by the North
Carolina State Building Code. Volume IV. This
emergency circuit shall be provided with a mini-
mum of two duplex receptacles identified for
emergency use. Additional emergency branch
circuits/receptacles shall be provided where the
electrical life support needs of the patient exceed
the minimum requirements stated in this Para-
graph. Each emergency circuit serving ventilator
dependent patients shall be fed from the automati-
cally transferred critical branch of the essential
electrical system. This Paragraph shall apply to
both new and existing facilities.
(8) Heating equipment provided for ventilator depend-
ent patient bedrooms shall be connected to the
critical branch of the essential electrical system
and arranged for delayed automatic or manual
connection to the emergency power source if the
10:2
NORTH CAROLINA REGISTER
April 17, 1995
116
PROPOSED RULES
heating equipment depends upon electricity for
proper operation. This Paragraph shall apply to
both new and existing facilities.
(9) Task lighting connected to the automatically
transferred critical branch of the essential electri-
cal system shall be provided for each ventilator
dependent patient bedroom. This Paragraph shall
a pply to both new and existing facilities.
(10) Where electricity is the only source of power
normally used for space heating, the emergency
service shall provide for heating of patient rooms.
Emergency heating of patient rooms will not be
required in areas where the facility is su pplied by
at least two separate generating sources, or a
network distribution system with the facility
feeders so routed, connected, and protected that a
fault any place between the generators and the
facility will not likely cause an interruption.
(1 1) The emergency electrical system shall be so
controlled that after interruption of the normal
electric power su pply, the generator is brought to
full voltage and frequency and connected with 10
seconds through one or more primary automatic
transfer switches to all emergency lighting,
alarms, nurses' call, and equipment necessary for
maintaining telephone service. All other lighting
and equipment required to be connected to the
emergency system shall either be connected
through the 10 second primary automatic transfer
switching or shall be subsequently connected
through other automatic or manual transfer switch-
ing. Receptacles connected to the emergency
system shall be distinctively marked for identifica-
tion.
(12) Sufficient fuel shall be stored for the operation of
the emergency generator for a period not less than
72 hours, on a 24-hour per day operational basis.
The generator system shall be tested and main-
tained per National Fire Protection Association
(NFPA) code 99. current addition with all subse-
quent amendments, which is adopted by reference.
Copies of this code may be obtained from the
National Fire Protection Association. I
Batterymarch Park. P.O. Box 9101. Quincy. MA
02269-9101 at a cost of thirty one dollars
($31.00). Records of running time shall be
maintained and kept available for reference.
(13) Existing facilities shall have electrical systems that
comply with licensure standards in effect at the
time a license is first issued. Any remodeling that
results in changes in service delivery shall comply
with current licensure requirements to su pport the
delivery of those services.
Statutory Authority G.S. 13 IE- 104.
.3403 GENERAL ELECTRICAL
(a) All main water supply shut off valves in the sprinkler
system shall be electronically supervised so that if any valve
is closed an alarm will sound at a continuously manned
central station.
(b) No two adjacent emergency lighting fixtures shall be
on the same circuit.
(c) Receptacles in bathrooms shall have ground fault
protection.
(d) For new construction, and remodeling of spaces to be
used as patient rooms that involve modification of the
electrical system in patient rooms, each patient bed location
shall be provided with a minimum of four single or two
duplex receptacles. Two sin gle receptacles or one duplex
receptacle shall be connected to the critical branch of the
emergency power system at each bed location. Each patient
bed location shall also be provided with a minimum of two
single receptacles or one duplex receptacle connected to the
normal electrical system.
(e) Each patient bed location shall be su pplied by at least
two branch circuits.
(f) The fire alarm system shall be installed to transmit an
alarm automatically to the fire department that is legally
committed to serve the area in which the facility is located,
by the most direct and reliable method a pproved by local
ordinances.
(g) In patient areas, fire alarms shall be gongs or chimes
rather than horns or bells.
(h) All receptacles in patient use areas must be grounded
by an insulated conductor sized in accordance with Table
250-95 of the North Carolina State Building Code. Volume
DL
Statutory Authority G.S. 131E-104.
.3404 OTHER
(a) In general patient areas, each room shall be served by
at least one calling station and each bed shall be provided
with a call button. Two call buttons serving adjacent beds
may be served by one calling station. Calls shall register
with the floor staff and shall activate a visible signal in the
corridor at the patient's or resident's door. In
multi-corridor nursing units, additional visible signals shall
be installed at corridor intersections. In rooms containing
two or more calling stations, indicating lights shall be
provided at each station. Nurses' calling systems which
provide two-way voice communication shall be equipp ed
with an indicating light at each calling station which lights
and remains Ugh ted as long as the voice circuit is operating.
A nurses' call emergency button shall be provided for
patients' and residents' use at each patient and resident
toilet, bath, and shower.
(b) At least one telephone shall be available in each area
to which patients are admitted and additional telephones or
extensions as are necessary to ensure availability in case of
need.
(c) General outdoor lighting shall be provided adequate to
illuminate walkways and drive.
(d) A flow of hot water shall be within safety ranges
specified as follows:
117
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
Patient Areas ; 6 172 gallons per hour per bed and
at a temperature of 100 -116 degrees F; and
Dietary Services : 4 gallons per hour per bed and
at a minimum temperature of 140 degrees Fi and
Laundry Area z 4 J_/2 gallons per hour per bed and
at a minimum temperature of 140 degrees F.
(e) Plumbing systems shall meet the requirements of the
North Carolina State Building Code, Volume U.
(f) Medical gas and vacuum systems shall be installed,
tested, and maintained in accordance with the National Fire
Protection Code 99 current addition with all subsequent
amendments, which is adopted by reference. Copies of this
code may be obtained from the National Fire Protection
Association, 1 Battery march Park. P.O. Box 9101.
Ouincy.MA 02269-9101 at a cost of thirty one dollars
($3 1.00).
(g) The Administrator shall assure that isolation facilities
as approved by the Department are available and used for
any patient admitted or retained with a communicable
disease.
(h) Each facility shall have a wanderer control system to
aid staff in the supervision of patients who wander or are
disoriented.
Statutory Authority G.S. 131E-104.
Notice is hereby given in accordance with G.S.
150B-21.2 that the Director of the Division Of Mental
Health, Developmental Disabilities and Substance Abuse
Services intends to amend rule cited as 10 NCAC 18J . 0803.
Proposed Effective Date: July 1, 1995.
OTHER PROGRAMS
SUBCHAPTER 18J - AREA PROGRAM
MANAGEMENT STANDARDS
SECTION .0800 - ESTABLISHMENT OF AN
AREA AUTHORITY APPEALS PANEL
.0803 APPEALS PROCEDURES
(a) Appeals of the decision of local area authorities shall
be forwarded, along with all supplementary documentation
considered during the local area appeals process, to the
Division Director within 44 15 days of the local decision
being rendered.
(b) The Division Director shall forward all information to
the Chair of the Panel within five working days.
(c) The Panel shall complete an administrative review and
notify the appealing party and the area program of its
decision, in writing, within +4 J_5 days of receipt of the
appeal. Unless further appealed within 44 15 days of the
date of this decision, this decision shall be considered final.
(d) Either party named in the appeal may request a
hearing by the Panel before the Panel's administrative
decision is considered to be final, by submitting a written
request to the Chair of the Panel, within 44 15 days of the
date of the administrative review decision.
(e) A hearing shall be scheduled by the Panel no more
than 30 days after a written request for a hearing is received
by the Chair.
(f) The hearing shall be scheduled at a time and place
designated by the Chair.
(g) The appealing party and the area program shall be
notified of the time and place of the hearing no less than 44
15 days prior to the hearing.
A Public Hearing will be conducted at 10:00 a.m. on May
17, 1995 at the Division ofMH/DD/SAS, Albemarle Bldg. ,
325 N. Salisbury St., Room 1112, Raleigh, NC 27603.
Statutory Authority G.S. 122C-1 12(a); 122C-151.4.
*«•«•••*****«***«*
Reason for Proposed Action: To provide area programs
with a time frame that is consistent in the Appeals Proce-
dures for the Division and for Carolina Alternatives.
Comment Procedures: Any interested person may present
comments by oral presentation or submitting a written
statement. Persons wishing to make oral presentations
should contact Charlotte Tucker, Division ofMH/DD/SAS,
325 N. Salisbury St. , Raleigh, NC 27603, 919-733-4774.
Comments submitted as a written statement must be sent to
the above address no later than May 17, 1995, and must
state the rule to which the comments are addressed. Time
limits for oral remarks may be imposed.
Fiscal Note: This Rule does not affect the expenditures or
revenues of local government or state funds.
CHAPTER 18 - MENTAL HEALTH:
Notice is hereby given in accordance with G.S.
150B-21.2 that the DHR/Division of Medical Assistance
intends to amend rules cited as 10 NCAC 26B .0124 and
26H .0213.
Proposed Effective Date: July 1, 1995.
A Public Hearing will be conducted at 1:30 p.m. on May
17, 1995 at the North Carolina Division of Medical Assis-
tance, 1985 Umstead Drive, Room 132, Raleigh, NC.
Reason for Proposed Action:
10 NCAC 26B .0124 - Some parts of the state, particularly
the rural areas, have a shortage of qualified supervisors for
HIV case management services. Allowing graduates of
accredited schools of professional nursing to become
qualified HIV case management supervisors will increase the
access of services throughout the state.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
118
PROPOSED RULES
10 NCAC 26H .0213 - To amend the North Carolina
Hospital Inpatient Reimbursement Plan effective January 1 ,
1995 to establish a disproportionate share pool for those
hospitals that qualify as disproportionate share hospital and
also operate a Medicare approved graduate medical educa-
tion program.
Comment Procedures: Written comments concerning this
rule-making action must be submitted by May 17, 1995 to:
Division of Medical Assistance, 1985 Umstead Drive,
Raleigh, NC 27603, ATTN: Portia Rochelle, APA Coordina-
tor. Oral comments may be presented at the hearing. In
addition, a fiscal note is available upon written request from
the same address.
Fiscal Note: 10 NCAC 26H .0124 affects the expenditure
or distribution of State funds subject to the Executive Budget
Act, Article 1 of Chapter 143. 10 NCAC 26H . 0213 does
not have a fiscal impact.
CHAPTER 26 - MEDICAL ASSISTANCE
SUBCHAPTER 26B - MEDICAL ASSISTANCE
PROVIDED
SECTION .0100 - GENERAL
.0124 HTV CASE MANAGEMENT
(a) The components of HIV case management are listed
below. In order to be reimbursed by the Division of
Medical Assistance, a provider shall provide all of these
components:
(1) Evaluation of the client's situation to determine
the need for initial case management services;
(2) Comprehensive assessment of the client's health
care, psychosocial, environmental and financial
needs;
(3) Development and implementation of a plan of
care which includes goals, services to be pro-
vided and progress notes;
(4) Coordination of service delivery when multiple
providers or programs are involved in care
provision;
(5) Monitoring to ensure that services received meet
the client's needs and are consistent with good
quality of care;
(6) Follow-up an assessment to determine the con-
tinued appropriateness of services, the correct
level of care, and the continued need for ser-
vices;
(7) Discharge of the client from service; and
(8) Locating and helping access available systems,
resources and services within the community to
meet the client's needs.
(b) Persons are eligible to receive HIV case management
services if they:
(1) Have a medical diagnosis of HTV disease or HIV
seropositivity; and
(2) Are eligible for regular Medicaid services; and
(3) Are not institutionalized; and
(4) Are not recipients of other Medicaid-reimbursed
case management services provided through the
State's home and community-based waivers or
the State Plan.
(c) Provider Qualifications. Providers of HIV case
management services shall:
(1) Be enrolled in accordance with section
1902(a)(23) of the Social Security Act; and
(2) Meet applicable State and Federal Laws govern-
ing the participation of providers in the Medicaid
program; and
(3) Be certified by the AIDS Care Branch, Division
of Adult Health Promotion, Department of
Environment, Health and Natural Resources as
a qualified HTV case management provider. To
be certified, a provider must:
(A) Submit an application to the AIDS Care
Branch that includes the provider's plans for :
(i) Provision of all the HIV case management
components in 10 NCAC 26B .0124(a);
and
(ii) Quality assurance, including the monitor-
ing and evaluation of case management
records.
(B) Have qualified case managers with supervision
provided by a supervisor who meets the re-
quirements in 10 NCAC 26 B .0124(d), except
that case managers qualified under 10 NCAC
26B .0124(e)(4) shall have all their charts
reviewed and signed by such a supervisor.
(d) Supervisor Qualification. An HIV case management
supervisor shall meet the following qualifications:
(1) Have a master's level degree in a human service
area including, but not limited to, Social Work,
Sociology, Child Development, Maternal and
Child Health, Counseling, Psychology or Nurs-
ing and one year of experience in case manage-
ment; or
(2) Have a bachelor's degree in a human service
including, but not limited to, Social Work,
Sociology, Child Development, Maternal and
Child Health, Counseling, Psychology or Nurs-
ing and two years experience in case manage
m e nt. management: or
(3) Have graduated from an accredited school of
professional nursing and completed three years
of professional nursing experience, including
two years in Public Health. Be licensed to
practice as a registered nurse and have a mini-
mum of two years experience in case manage-
ment; or
(4) Have graduated from an accredited school of
professional nursing and completed three years
of professional nursing experience, including
two years experience supervising nurses respon-
sible for developing and maintaining care plans
119
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
»
I
I
and coordinating care and services for patients
receiving care in their homes. Be licensed to
practice as a registered nurse and have a mini-
mum of two years experience in case manage-
ment.
(e) Case Manager Qualifications. HIV case managers
shall meet the following qualifications:
(1) Have a master's degree in a human service area
including, but not limited to, Social Work,
Sociology, Child Development, Maternal and
Child Health, Counseling, Psychology or Nurs-
ing; or
(2) Have a bachelor's level degree in a human
service area including, but not limited to, Social
Work, Sociology, Child Development, Maternal
and Child Health, Counseling, Psychology or
Nursing and two years experience working in
human services; or
(3) Be a licensed Registered Nurse, Nurse Practitio-
ner, Physician Assistant or Certified Substance
Abuse Counselor with two years experience
working in human o e rvio e o. services; or
(4) Have a high school diploma and two years
experience providing HIV case management. A
person who qualifies under 10 NCAC 26B .0124
(e)(4) may serve as an HIV case manager for
five years from date of employment as an HIV
case manager in an agency certified to provide
HIV case management. If an agency is not a
certified HIV case management provider at the
time of the person's employment as an HIV case
manager, the five year time period begins with
the agency's certification date. After the five
year period ends, the person must meet HIV
case manager requirements defined in 10 NCAC
26B .0124 (c)(l),(2), or (3) in order to continue
to providing HIV case management services
services; or
(5) HTV case manages shall attend, at least annually,
training sessions approved by the AIDS Care
Branch, Division of Adult Health Promotion,
Department of Environment, Health and Natural
Resources.
Authority G.S. 108A-25(b); 108A-54; 42 C.F.R. 440.169;
Social Security Act 1915(b).
SUBCHAPTER 26H - REIMBURSEMENT
PLANS
SECTION ,0200 - HOSPITAL INPATIENT
REIMBURSEMENT PLAN
.0213 DISPROPORTIONATE SHARE HOSPITALS
(a) Hospitals that serve a disproportionate share of low-
income patients and have a Medicaid inpatient utilization
rate of not less than one percent are eligible to receive rate
adjustments. The cost report data and financial information
that is required in order to qualify as a disproportionate
share hospital effective April 1, 1991 is based on the fiscal
year ending in 1989 for each hospital, as submitted to the
Division of Medical Assistance on or before April 1, 1991.
The cost report data and financial information to qualify as
a disproportionate share hospital effective July 1, 1991 is
based on the fiscal year ending in 1990 for each hospital, as
submitted to the Division of Medical Assistance on or
before September 1, 1991. In subsequent years, qualifica-
tions effective July 1 of any particular year are based on
each hospital's fiscal year ending in the preceding calendar
year. The patient days, costs, revenues, or charges related
to nursing facility services, swing-bed services, home health
services, outpatient services, or any other service that is not
a hospital inpatient service cannot be used to qualify for
disproportionate share status. A hospital is deemed to be a
disproportionate share hospital if:
(1) The hospital has at least two obstetricians with
staff privileges at the hospital who have agreed
to provide obstetric services to individuals
eligible for Medicaid. In the case of a hospital
located in a rural area, the term obstetrician
includes any physician with staff privileges at
the hospital to perform non-emergency obstetric
services as of December 21, 1987 or to a hospi-
tal that predominantly serves individuals under
18 years of age; and
(2) The hospital's Medicaid inpatient utilization rate,
defined as the percentage resulting from dividing
Medicaid patient days by total patient days, is at
least one standard deviation above the mean
Medicaid inpatient utilization rate for all hospi-
tals that receive Medicaid payments in the state;
or
(3) The hospital's low income utilization rate ex-
ceeds 25 percent. The low-income utilization
rate is the sum of:
(A) The ratio of the sum of Medicaid inpatient
revenues plus cash subsidies received from the
State and local governments, divided by the
hospital's total patient revenues; and
(B) The ratio of the hospital's gross inpatient
charges for charity care less the cash subsidies
for inpatient care received from the State and
local governments divided by the hospital's
total inpatient charges; or
(4) The sum of the hospital's Medicaid revenues,
bad debts allowance net of recoveries, and
charity care exceeds 20 percent of gross patient
revenues; or
(5) The hospital, in ranking of hospitals in the State,
from most to least in number of Medicaid
patient days provided, is among the top group
that accounts for 50% of the total Medicaid
patient days provided by all hospitals in the
State; or
10:2
NORTH CAROLINA REGISTER
April 17, 1995
120
PROPOSED RULES
(6) Psychiatric Hospitals operated by the North
Carolina Department of Human Resources,
Division of Mental Health, Developmental
Disabilities, Substance Abuse Services
(DMH/DD/SAS) and UNC Hospitals operated
by the University of North Carolina.
(b) The rate adjustment for a disproportionate share
hospital is 2.5 percent plus one fourth of one percent for
each percentage point that a hospital's Medicaid inpatient
utilization rate exceeds one standard deviation of the mean
Medicaid inpatient utilization rate in the State. The rate
adjustment is applied to a hospital's payment rate exclusive
of any previous disproportionate share adjustments.
(c) Effective July 1, 1994, hospitals eligible under
Subparagraph (a)(6) of this Rule will be eligible for dispro-
portionate share payments, in addition to other payments
made under the North Carolina Medicaid Hospital reim-
bursement methodology, from a disproportionate share pool
under the circumstances specified b e low: in Subparagraphs
(1), (2) and (3) of this Paragraph.
(1) An eligible hospital will receive a monthly
disproportionate share payment based on the
monthly bed days of services to low income
persons of each hospital divided by the total
monthly bed days of services to low income
persons of all hospitals items allocated funds.
(2) This payment shall be in addition to the dispro-
portionate share payments made in accordance
with Subparagraphs (a)(1) through (5) of this
Rule. However, DMH/DD/SAS operated
hospitals are not required to qualify under the
requirements of Subparagraphs (a)(1) through
(5) of this Rule.
(3) The amount of allocated funds shall be deter-
mined by the Director of the Division of Medi-
cal Assistance, but not to exceed the quarterly
grant award of funds (plus appropriate non-
federal match) earmarked for disproportionate
share hospital payments less payments made
under Subparagraphs (a)(1) through (5) divided
by three.
In Subparagraph (c)(1) of this Rule, bed days of services
to low income persons is defined as the number of bed days
provided to individuals that have been determined by the
hospital as patients that do not possess the financial re-
sources to pay portions or all charges associated with care
provided.
Low income persons include those persons that have been
determined eligible for medical assistance. The count of
bed days used to determine payment is based upon the
month immediately prior to the month that payments are
made.
Disproportionate share payments to hospitals are limited
in accordance with The Social Security Act as amended,
Title XIX section 1923 (g), limit on amount of payment to
hospitals.
(d) Effective January L. 1995 and subject to the availabil-
ity of funds, hospitals that qualify as disproportionate share
hospitals under Subparagraphs (aid) through (5) of this
Rule and that also operate Medicare a pproved graduate
medical education programs will be eligible for dispropor-
tionate share payments for hospital inpatient services in
addition to other payments made under the North Carolina
Medicaid Hospital DRG reimbursement methodology from
a disproportionate share pool under the circumstances
specified in Subparagraphs (1) and (2) of this Paragraph:
(1) Qualifications effective January 1, 1995 through
September 30. 1995 are based on cost report
data and financial information for the fiscal year
ending in 1993 as submitted to the Division of
Medical Assistance on or before September l±
1994. Qualifications for the 12 month period
beginning October 1^ 1995 and subsequent 12
month periods beginning October I of each year,
will be based on cost report data and financial
information for the fiscal year ending in the
preceding calendar year, as submitted to the
Division of Medical Assistance on or before
September 1 immediately preceding the 12
month period beginning October 1 for which
eligibility is being determined.
(2) Additional payments for the period from January
L. 1995 throug h September 30. 1995 will be
made based on hospital cost per case mix index
adjusted discharge, as established by Exhibit 5.1
contained in the report entitled "DRG-Based
Prospective Payment Methodology for Inpatient
Services" dated January 25. 1995 prepared by
Myers and Stauffer. Chartered Certified Public
Accountants, for the North Carolina Division of
Medical Assistance and arranged from low to
high as specified in Parts (A) and (B) of this
Subparagraph:
(A) Hospitals with a calculated cost per case mix
index adjusted discharge cost of three thousand
one hundred fifty six dollars ($3.156) or less
will be entitled to an additional payment in an
amount that when added to other Medicaid
payments may not exceed 100% of allowable
Medicaid costs, as determined by the Medicare
principles of cost reimbursement;
(B) Hospitals with a calculated cost per case mix
index adjusted discharge cost of more than
three thousand one hundred fifty six dollars
($3.156) will be entitled to additional payments
in an amount that when added to other Medic-
aid payments may not exceed 85% of allow-
able Medicaid costs, as determined by Medi-
care principles of cost reimbursement.
(3) Additional payments for the 12 month period
beginning October J^ 1995 and for each subse-
quent 12 month period will be determined as
specified in Parts (A). (B) and (C) of this Sub-
paragraph:
(A) The calculated cost per case mix index ad-
justed discharge amount of three thousand one
121
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
>
hundred fifty six ($3.156) shall be updated
annually by the National Hospital Market
Basket Index and the most recent actual and
projected cost data available from the North
Carolina Office of State Budget and Manage-
ment;
(B) Each hospital's cost per case mix index ad-
justed discharge will be ascertained by analysis
of charges for Medicaid inpatient claims reim-
bursed under the DRG methodology and paid
during the immediately preceding calendar
year, multiplied by each hospital's ratio of cost
to charges derived from cost report data and
financial information for the fiscal year of each
hospital ending in the preceding calendar year,
as submitted to the Division of Medical Assis-
tance on or before the first day of September
immediately preceding the 12 month period
beginning October 1. for which eligibility is
being determined; and
(C) Hospitals with a case mix index adjusted
discharge cost equal to or less than three
thousand one hundred fifty six ($3.156) plus
any annual updated amount will be entitled to
an additional payment in an amount that when
added to other Medicaid payments may not
exceed 100% of allowable Medicaid costs, as
determined by the Medicare principles of cost
reimbursement; hospitals with calculated costs
per case mix index adjusted discharge greater
than three thousand one hundred fifty six
($3.156) plus any annual updated amount will
be entitled to additional payments in an amount
that when added to other Medicaid payment
does not exceed 85% of allowable Medicaid
costs, as determined by Medicare principles of
cost reimbursement.
(4) Payments will be made on an estimated basis no
less frequently than quarterly during the period
for which such payments are to be made-
Estimated payments will be based on costs
incurred and payments received for Medicaid
inpatient DRG services during the most recent
fiscal year for which the Division of Medical
Assistance has a completed cost report. Esti-
mated payments made to each hospital will be
cost settled as determined by an independent
CPA furnished by the provider, based on cost
reports for the period for which payments are
made, and appropriate adjustments will be made
to assure that such payments do not exceed the
hospital's net cost of providing services to
Medicaid patients.
(5) Payments may not exceed the amount of funds
available as determined by the Director of the
Division of Medical Assistance. Should avail-
able funds be insufficient to pay_ in full the
(61
authorized payments, the Division of Medical
Assistance shall ascertain maximum payments
allowable and the funds available to qualifying
hospitals shall be prorated on that basis.
The changes to disproportionate share payments
authorized by this Paragraph are in accordance
with G.S. 108A-55(c).
Authority G.S. 108A-25(b); 108A-54; 108A-55; 42 C.F.R.
447, Subpart C.
TITLE 12 - DEPARTMENT OF
JUSTICE
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Criminal Justice
Education and Training Standards Commission intends to
amend rules cited as 12 NCAC 9A .0204; 9B .0113, .0201 -
.0202, .0205 - .0206, .0210, .0212 - .0214, .0226 - .0228,
.0232 -.0233; 9C .0401, .0601; 9D .0102, .0104 - .0106.
Proposed Effective Date: August 1, 1995.
A Public Hearing will be conducted at 9:00 a.m. on June
1, 1995 at the Hearing Room of the Alcoholic Beverage
Control Commission Building, 3322 Garner Road, Raleigh,
NC.
Reason for Proposed Action: The Standards Commission
has authorized rule-making authority to propose amending
several of its administrative rules in order to better define
the minimum standards that regulate the criminal justice
officer profession as well as the criminal justice training
schools. Additionally, the Commission is updating several
incorrect rule references to G. S. 150B and is adding eight
new types of radar instruments to the approved list.
Comment Procedures: Any person interested in these rules
may present oral or written comments relevant to the
proposed action at the Public Rule-Making Hearing. In
addition, the record of hearing will be open for receipt of
written comments from April 17, 1995 to June 1, 1995.
Written comments not presented at the hearing should be
directed to David D. Cashwell, Criminal Justice Standards,
P. O. Box 149, Raleigh, NC 27602. The proposed rules are
available for public inspection and copies may be obtained
at the following address: Criminal Justice Standards, P.O.
Box 149, Raleigh, NC 27602 (Room 150, Court of Appeals
Building, 1 West Morgan St. , Raleigh, NC).
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
CHAPTER 9 - CRIMINAL JUSTICE
EDUCATION AND TRAINING STANDARDS
10:2
NORTH CAROLINA REGISTER
April 17, 1995
122
PROPOSED RULES
SUBCHAPTER 9A - CRIMINAL JUSTICE
EDUCATION AND TRAINING STANDARDS
COMMISSION
SECTION .0200 - ENFORCEMENT OF RULES
.0204 SUSPENSION: REVOCATION:
OR DENIAL OF CERTIFICATION
(a) The Commission shall revoke the certification of a
criminal justice officer when the Commission finds that the
officer has committed or been convicted of:
(1) a felony offense; or
(2) a criminal offense for which the authorized
punishment included imprisonment for more than
two years.
(b) The Commission may suspend, revoke, or deny the
certification of a criminal justice officer when the Commis-
sion finds that the applicant for certification or the certified
officer:
(1) has not enrolled in and satisfactorily completed
the required basic training course in its entirety
within prescribed time periods relevant or appli-
cable to a specified position or job title;
(2) fails to meet or maintain one or more of the
minimum employment standards required by 12
NCAC 9B .0100 for the category of the officer's
certification or fails to meet or maintain one or
more of the minimum training standards re-
quired by 12 NCAC 9B .0200 or 12 NCAC 9B
.0400 for the category of the officer's certifica-
tion;
(3) has committed or been convicted of:
(A) a criminal offense or unlawful act defined in
12 NCAC 9A .0103 as a Class B misde-
meanor; or
(B) four or more criminal offenses or unlawful
acts defined in 12 NCAC 9A .0103 as a Class
A misdemeanor, each of which occurred after
the date of initial certification;
(4) has been discharged by a criminal justice agency
for commission or conviction of:
(A) a motor vehicle offense requiring the revoca-
tion of the officer's driver's license; or
(B) any other offense involving moral turpitude;
(5) has been discharged by a criminal justice agency
because the officer lacks the mental or physical
capabilities to properly fulfill the responsibilities
of a criminal justice officer;
(6) has knowingly made a material misrepresentation
of any information required for certification or
accreditation;
(7) has knowingly and willfully, by any means of
false pretense, deception, defraudation, misrep-
resentation or cheating whatsoever, obtained or
attempted to obtain credit, training or certifica-
tion from the Commission;
(8) has knowingly and willfully, by an means of
false pretense, deception, defraudation, misrep-
(9)
(10)
(11)
(12)
(13)
(14)
resentation or cheating whatsoever, aided an-
other person in obtaining or attempting to obtain
credit, training or certification from the Com-
mission;
has failed to make either of the notifications as
required by 12 NCAC 9B .0101(7);
has been removed from office by decree of the
Superior Court in accord with the provisions of
G.S. 128-16 or has been removed from office by
sentence of the court in accord with the provi-
sions of G.S. 14-230;
fails to satisfactorily complete the minimum
in-service training requirements as prescribed in
12 NCAC 9E;
has refused to submit to an applicant or lateral
transferee drug screen as required by these
Rules; ef
has produced a positive result on a drug screen
reported to the Commission as specified in 12
NCAC 9C .0310, where the positive result
cannot be explained to the Commission's satis
faction, satisfaction; or
♦
has been denied certification or had such justice
officer certification suspended or revoked by the
North Carolina Sheriffs' Education and Training
Standards Commission.
(c) Following suspension, revocation, or denial of the
person's certification, the person may not remain employed
or appointed as a criminal justice officer and the person may
not exercise any authority of a criminal justice officer
during a period for which the person's certification is
suspended, revoked, or denied.
Statutory Authority G.S. 17C-6; 17C-10.
SUBCHAPTER 9B - STANDARDS FOR
CRIMINAL JUSTICE EMPLOYMENT:
EDUCATION: AND TRAINING
SECTION .0100 - MINIMUM STANDARDS
FOR CRIMINAL JUSTICE EMPLOYMENT
.0113 MINIMUM STANDARDS PROBATION/
PAROLE OFFICERS-SURVEDLLANCE
In addition to the requirements for criminal justice officers
contained in Rule .0101 of this Section, every proba-
tion/parole officer-surveillance shall hav e attain e d — the
associate dogroo or have satisfactorily completed at least 60
semester hours of educational credit or 90 quarter hours of
e duoational — orodit at an aoor e ditod — t e chnical — institut e ,
t e ohnioal — ooll e g e , — community — coll e g e , — junior coll e g e ,
collogo, or university, be a high school graduate or have
passed the General Educational Development Test indicating
high school equivalency.
Statutory Authority G.S. 17C-6.
SECTION .0200 - MINIMUM STANDARDS
123
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
FOR CRIMINAL JUSTICE SCHOOLS AND
CRIMINAL JUSTICE TRAINING PROGRAMS
OR COURSES OF INSTRUCTION
.0201 ADMINISTRATION OF CRIMINAL
JUSTICE SCHOOLS
(a) The executive officer or officers of the institution or
agency sponsoring any criminal justice training program or
course of instruction shall have primary responsibility for
implementation of these Rules and standards and for
administration of the school. The executive officer or
officers of the institution or agency shall secure School
Accreditation pursuant to 12 NCAC 9C .0401 prior to
offering any criminal justice training course.
(b) The executive officers shall designate not more than
one compensated staff member for each
commission-accredited program for which the institution or
agency has been granted accreditation. Such staff member
shall be formally certified by the Commission under Section
.0500 of this Subchapter to be the criminal justice school
director. The school director shall have administrative
responsibility for planning, scheduling, presenting, coordi-
nating, reporting, and generally managing each sponsored
accredited criminal justice training course. If the accredited
institution or agency assigns additional responsibilities to the
certified school director during the planning, development,
and implementation of an accredited basic recruit training
course, an additional qualified staff person must be desig-
nated to assist the school director in the administration of
the course. This person must be selected by the school
director and must attend a course orientation conducted by
Standards Division staff and attend the annual School
Directors' Conference.
(c) The executive officers shall permanently maintain
records of all criminal justice training courses sponsored or
delivered by the school, reflecting:
(1) course title;
(2) delivery hours of course;
(3) course delivery dates;
(4) names and addresses of instructors utilized
within designated subject-matter areas; and
(5) a roster of enrolled trainees, showing class
attendance and designating whether each
trainee's course participation was successful or
unsuccessful;
(6) copies of all rules, regulations and guidelines
developed by the school director;
(7) documentation of any changes in the initial
course outline, including substitution of instruc-
tors; and
(8) documentation of make-up work achieved by
each individual trainee, including test scores and
methods.
(d) The executive officers of the institution or agency
sponsoring any criminal justice training program or course
of instruction shall meet or exceed the following specifica-
tions:
(1) acquire and allocate sufficient financial resources
to provide commission certified instructors and
to meet other necessary program expenses;
(2) provide adequate secretarial, one designated
clerical , and other supportive staff aoaiatanoo as
required by th e oohool dir e ctor su pport person to
assist the school director in maintaining required
records, complete reports, and provide other
clerical needs as required by the school director;
(3) provide or make available suitable facilities,
equipment, materials, and supplies for compre-
hensive and qualitative course delivery, specifi-
cally including the following:
(A) a comfortable, well-lighted and ventilated
classroom with a seating capacity sufficient to
accommodate all attending trainees;- specifi-
cally:
(i) provide a minimum of 24 square feet of
floor space per trainee;
(ii) provide over-head lighting measuring at a
minimum. 70 foot candles at desk level;
(iii) provide an adult size table and chair for
each trainee;
(B) audio-visual equipment and other instructional
devices and aids necessary and beneficial to
the delivery of effective training;
(C) a library for trainees' use covering the sub-
ject-matter areas relevant to the training
course, maintained in current status and having
sufficient copies for convenient trainee access;
(D) wh e r e r e quir e d by cours e content, provid e or
make — available — facilitie s , — equipment, — aad
supplie s to provide training in physical and
motor skill exorcis e s suoh as d e f e noiv e taotioo,
fir e arms qualification, and purouit/dofonoivo
driving, a firearms firing range designed for
criminal justice firearms instruction to conduct
the basic recruit firearms course, with the
following specifications:
(i) an operational public address system of
sufficient volume to be audible to persons
wearing ear plugs or other hearing protec-
tion while firearms are being discharged:
(ii) an emergency first-aid kit:
(iii) access limited to criminal justice trainees,
criminal justice instructors, and personnel
authorized by the school director when
firearms are being discharged;
(iv) warning signs posted at all access points
which clearly identify the area as a crimi-
nal justice firing range;
(v) restrooms. drinking water and a rain-resis-
tant shelter for personnel engaged jb train-
ing; and
(vi) telephone or radio communications imme-
diately available to range instructors;
(E) a driving range designated for criminal justice
10:2
NORTH CAROLINA REGISTER
April 17, 1995
124
PROPOSED RULES
training, adequate in size and design to safely
conduct the law enforcement basic recruit
driving course, with the following specifica-
tions:
(i) secured by barriers from through traffic
while training is being conducted on the
range;
(ii) warning signs posted at all vehicle access
points that shall clearly identify the area as
a law enforcement training driving range
and limit access to criminal justice train-
ees, criminal justice instructors, and per-
sonnel authorized by the school director;
(iii) an emergency first-aid kit;
(iv) access to at least two automobiles designed
and equipped for criminal justice driver
training;
(v) restrooms and drinking water for person-
nel engaged in training; and
(vi) telephone or radio communications imme-
diately available to range instructors;
(F) a suitable area designated for criminal justice
defensive tactics instruction which enables the
safe execution of the basic recruit defensive
tactics course, with the following specifica-
tions:
(i) permanent or portable cushioned floor
matting;
(ii) an emergency first-aid kit: and
(iii) telephone or radio communications imme-
diately available to defensive tactics in-
structors;
(G) a suitable area for the conducting of physical
fitness training, with the following specifica-
tions:
(i) an obstacle course designed and con-
structed according to specifications out-
lined in the Basic Law Enforcement Train-
ing Course Management Guide;
(ii) a ppropriate space for running, weight
training, calisthenics; and aerobics;
(iii) restrooms and drinking water for person-
nel engaged in training;
(iv) shower facilities, if physical fitness train-
ing is conducted prior to classroom train-
ing.
(e) Th e sponsoring institution, unless it i s an ag e noy or
department aocroditod by the Commiaoion to provide basic
training to its own per s onnel, is not required to assumo the
oosts of providing the following sp e oifi e d e quipm e nt and
supplies for train ee uc e during oouro e d e liv e r) 1 : In the event
that an institution or agency does not own a required
facility, written agreements with other entities must be made
to assure use of and timely access to such facilities. A copy
of such agreement must be on file for review by Standards
Division staff.
ft} firearms (handgun and shotgun),
(3) firearm ammunition (praotio e and qualifying),
motof vehicle,
polio e baton,
m-
gas mask,
handcuff s , or
m —
(7) radar, radar and time distance or time distance
speed moaouromont instrum e nts. —
(f) Th e oohool rules may requ i re the employing ag e noy or
department to moke the equipment and supplies listed in
Paragraph (o) of this Rule available at the appropriate
ooh e dul e d time during oouro e deliv e ry for the us e of its own
train ee offio e r s . Each institution or agency accredited to
deliver basic recruit training shall provide access to supplies
and equipment for trainee use during course delivery as
specified in the Basic Law Enforcement Training Course
Management Guide.
Statutory Authority G.S. 17C-6.
.0202 RESPONSIBILITIES OF THE SCHOOL
DIRECTOR
(a) In planning, developing, coordinating, and delivering
each commission-accredited criminal justice Gaining course,
the school director shall:
(1) Formalize and schedule the course curriculum in
accordance with the curriculum standards estab-
lished by the Commission.
(A) The school director shall schedule course
presentation for delivery as follows:
(i) Each basic training course required for
criminal justice officer certification shall
be presented with a minimum of 12 hours
of instruction each week during consecu-
tive calendar weeks except that there may
be as many as three one-week breaks until
course requirements are completed. This
Rule shall not apply to presentations of the
"Basic Training— State Youth Services
Officers" course.
(ii) The "Criminal Justice Instructor Training
Course" shall be presented with a mini-
mum of 40 hours of instruction each week
during consecutive calendar weeks until
course requirements are completed.
(B) In the event of exceptional or emergency
circumstances, the Director of the Standards
Division may, upon written finding of justifi-
cation, grant a waiver of the minimum hours
requirement.
(2) Select and schedule qualified instructors who are
properly certified by the Commission. The
selecting and scheduling of instructors is subject
to special requirements as follows:
(A) In the presentation of a delivery of the "Basic
Recruit Training—Law Enforcement" course:
(i) No instructor shall be scheduled to in s truct
instruct, either as the lead instructor or in
any other capacity, in a high liability topic
area as identified under Rule .0304(a) of
I
♦
125
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
m
this Subchapter unless specifically certified
for that topic area by the Commission.
With the exception of the First Responder,
Physical Fitness. Medical Emergencies
(DYS), and Electrical and Hazardous
Materials Emergencies topical areas as
outlined in Rule .0304(a) of this Subchap-
ter, there shall be one specific certified
instructor for each six trainees while ac-
tively engaged in a practical performance
I
(A)
(B)
(Q
I
(in) (£) No single individual may be scheduled
to instruct more than 35 percent of the
total hours of the curriculum during any
one delivery of the "Basic Recruit Train-
ing—Law Enforcement" course presenta-
tion.
(iv) {i«)Where the school director shows ex-
ceptional or emergency circumstances and
the school director documents that an (7)
instructor is qualified to instruct more than
35 percent of the total hours of the curric- (8)
ulum, the Director of the Standards Divi-
sion may grant written approval for the
expansion of the individual instructional
limitation.
(B) In the presentation of a delivery of the "Crimi-
nal Justice Instructor Training Course": (A)
(i) At least one evaluator of trainee perfor-
mance shall be scheduled for each six
trainees and in course delivery no evalua- (B)
tor will be assigned more than six trainees,
(ii) Each evaluator, as well as the instructors,
must have successfully completed a com-
mission-accredited instructor training (C)
course or an equivalent instructor training
course as determined by the Commission.
(iii) Each instructor and evaluator must docu-
ment successful participation in a special (9)
program presented by the Justice Academy
for purposes of familiarization and supple-
mentation relevant to delivery of the in-
structor training course and trainee evalua-
tion. (A)
(3) Provide each instructor with a commis-
sion-approved course outline and all necessary (B)
additional information concerning the instruc-
tor's duties and responsibilities.
(4) Review each instructor's lesson plans and other (C)
instructional materials for conformance to estab-
lished commission standards and to minimize (D)
repetition and duplication of subject matter.
(5) Arrange for the timely availability of appropriate (E)
audiovisual aids and materials, publications,
facilities and equipment for training in all topic
areas.
(6) Develop, adopt, reproduce, and distribute any (10)
supplemental rules, regulations, and require-
ments determined by the school to be necessary
or appropriate for:
effective course delivery;
establishing responsibilities and obligations of
agencies or departments employing course
trainees; and
regulating trainee participation and demeanor
and ensuring trainee attendance and maintain-
ing performance records.
A copy of such rules, regulations and require-
ments shall be submitted to the Director of the
Standards Division as an attachment to the
Pre-delivery Report of Training Course Pre-
sentation. A copy of such rules shall also be
given to each trainee and to the executive
officer of each trainee's employing agency or
department at the time the trainee enrolls in
the course.
If appropriate, recommend bousing and dining
facilities for trainees.
Not less than 15 days before commencing deliv-
ery of the "Basic Recruit Training—Law En-
forcement" course, submit to the commission a
Pre-delivery Report of Training Course Presen-
tation (Form F-10A) along with the following
attachments:
A comprehensive course schedule showing
arrangement of topical presentations and pro-
posed instructional assignments.
A copy of any rules, regulations, and require-
ments for the school and, when appropriate,
completed applications for Professional Lec-
turer Certification.
The Director of the Standards Division shall
review the submitted Pre-delivery Report
together with all attachments and notify the
school director of any apparent deficiency.
Not less than 30 days before commencing deliv-
ery of the "Criminal Justice Instructor Training
Course", submit to the commission a
Pre-delivery Report of Training Course Presen-
tation with the following attachments:
The name and credentials of the school direc-
tor.
A comprehensive course schedule showing
arrangement of topical presentations and pro-
posed instructional assignments.
The names and credentials of all instructors
and e valuators.
A copy of any rules, regulations, and require-
ments for the school.
The Director of the Standards Division shall
review the submitted Pre-delivery Report
together with all attachments and notify the
school director of any apparent deficiency.
Administer the course delivery in accordance
10:2
NORTH CAROLINA REGISTER
April 17, 1995
126
PROPOSED RULES
with commission-approved procedures, guide-
lines, and standards and ensure that the training
offered is as effective as possible.
(11) The school director or designated certified
instructor shall monitor the presentations of all
probationary instructors during course delivery
and prepare formal written evaluations on their
performance and suitability for subsequent
instructional assignments. These evaluations
shall be prepared on commission-approved forms
and forwarded to the Commission. Based on
this evaluation, the school director shall have the
added responsibility for recommending approval
or denial of requests for General Instructor
Certification.
(12) The school director or designated certified
instructor shall monitor the presentations of all
other instructors during course delivery and
prepare formal written evaluations on their
performance and suitability for subsequent
instructional assignments. Any designated
certified instructor who is evaluating the instruc-
tional presentation of another instructor shall, at
a minimum, hold certification in the same in-
structional topic area as that for which the
instructor is being evaluated. Instructor evalua-
tions shall be prepared on commission-approved
forms in accordance with commission standards.
These evaluations shall be kept on file by the
school for a period of three years and shall be
made available for inspection by a representative
of the Commission upon request.
(13) Administer or designate a qualified person to
administer appropriate tests as determined neces-
sary at various intervals during course delivery:
(A) to determine and record the level of trainee
comprehension and retention of instructional
subject-matter; and
(B) to provide a basis for a final determination or
recommendation regarding the minimum
degree of knowledge and skill of each trainee
to function as an inexperienced criminal justice
officer; and
(C) to determine subject or topic areas of defi-
ciency for the application of Rule .0405(a)(3)
of this Subchapter.
(14) Maintain direct supervision, direction, and
control over the performance of all persons to
whom any portion of the planning, development,
presentation, or administration of a course has
been delegated.
(15) During a delivery of the "Basic Recruit Train-
ing—Law Enforcement" course, make available
to authorized representatives of the Commission
four hours of scheduled class time and class-
room facilities for the administration of a written
examination to those trainees who have satisfac-
torily completed all course work.
(16) Report the completion of each presentation of a
commission-accredited criminal justice training
course to the Commission as follows:
(A) "Basic Recruit Training—Law Enforcement".
Not more than 10 days after receiving from
the Commission's representative the Report of
Examination Scores, the school director shall
submit to the Commission a Post-delivery
Report of Training Course Presentation (Form
F-10B).
(B) Special arrangements shall be made between
the school director and the Director of the
Standards Division for the reporting of law
enforcement achievement in a commis-
sion-accredited Public Safety Officer course.
(C) Upon successful completion of a commis-
sion-accredited training course by correctional,
state youth services, or probation/parole train-
ees, the director of the school conducting such
course shall notify the Commission of the
satisfactory achievement of trainees by submit-
ting a monthly Report of Training Course
Completion.
(D) "Criminal Justice Instructor Training Course".
Not more than 10 days after course completion
the school director shall submit to the Com-
mission a Post-delivery Report containing the
following:
(i) Class enrollment roster,
(ii) Course schedule with designation of in-
structors and evaluators utilized in deliv-
ery,
(iii) Scores recorded for each trainee on both
the 80 minute skill presentation and the
final written examination,
(iv) Designation of trainees who successfully
complete the course in its entirety and
whom the school director finds to be
competent to instruct,
(b) In addition to Paragraph (a) of this Rule, in planning,
developing, coordinating and delivering each commis-
sion-accredited radar, radar and time-distance or
time-distance speed measurement operator training course or
re-certification course, the school director shall:
(1) select and schedule qualified radar or
time-distance speed measurement instrument
instructors who are properly certified by the
Commission as instructors for the specific speed
measurement instruments in which the trainees
are to receive instruction. The following re-
quirements apply to operator certification train-
ing:
(A) Provide to the instructor the Commission
form(s) for motor-skill examination on each
trainee;
(B) Require the instructor to complete the mo-
tor-skill examination form on each trainee
indicating the level of proficiency obtained on
♦
127
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
each specific instrument;
(C) Require each instructor to sign each individual
form and submit the original to the school
director.
(2) not less than 30 days before the scheduled
starting date submit to the Director of the Stan-
dards Division a Request for Training Course
Presentation.
(A) The request shall contain a period of course
delivery including the proposed starting date,
course location and the number of trainees to
be trained in each type of approved
speed-measurement instrument;
(B) The Director of the Standards Division shall
review the request and notify the school direc-
tor of the accepted delivery period unless a
conflict exists with previously scheduled pro-
grams.
(3) during the delivery of the training course, make
available to authorized representatives of the
Commission two hours of scheduled class time
and classroom facilities for the administration of
a written examination to the trainee.
(4) upon completing delivery of the Commis-
sion-accredited course, and not more than 10
days after receiving from the Commission's
representative the Report of Examination Scores,
the school director shall notify the Commission
regarding the progress and achievements of each
trainee by submitting a Post-delivery Report of
Training Course Presentation. This report shall
include the original motor-skill examination
form(s) completed and signed by the certified
instructor responsible for administering the
motor-skill examination to the respective trainee.
Statutory Authority G.S. 17C-6.
.0205 BASIC TRAINING - LAW ENFORCEMENT
OFFICERS
(a) The basic training course for law enforcement officers
consists of instruction designed to provide the trainee with
the skills and knowledge to perform those tasks essential to
function in law enforcement.
(b) The course entitled "Basic Recruit Training — Law
Enforcement" shall consist of a minimum of 432 460 hours
of instruction and shall include the following identified topic
areas and minimum instructional hours for each area:
(1) Course Orientation 2 Hours
(2) Constitutional Law 4 Hours
(3) Laws of Arrest, Search and Seizure 16 Hours
(4) Mechanics of Arrest; Arrest
Procedures 8 Hours
(5) Law Enforcement Communications
and Information Systems 4 Hours
(6) Elements of Criminal Law 24 Hours
(7)
Defensive Tactics
16 Hours
(8)
Juvenile Laws and Procedures
8 Hours
(9)
First Responder
40 Hours
(10)
Firearms
40 Hours
(11)
Patrol Techniques
16 Hours
(12)
Crime Prevention Techniques
4 Hours
(13)
Field Notetaking and Report Writing
12 Hours
(14)
Mechanics of Arrest; Vehicle Stops
6 Hours
(15)
Mechanics of Arrest; Custody
Procedures
2 Hours
(16)
Mechanics of Arrest; Processing
Arrestee
4 Hours
(17)
Crisis Management
10 Hours
(18)
Special Populations
12 Hours
(19)
Civil Disorders
8 Hours
(20)
Criminal Investigation
28 Hours
(21)
Interviews: Field and In-Custody
8 Hours
(22)
Controlled Substances
6 Hours
(23)
ABC Laws and Procedures
4 Hours
(24)
Electrical and Hazardous Materials
Emergencies
12 Hours
(25)
Motor Vehicle Laws
20 Hours
(26)
Techniques of Traffic Law
Enforcement
6 Hours
(27)
Traffic Accident Investigation
20 Hours
(28)
Law Enforcement Driver
Training 44
44 Hours
(29)
Preparing for Court and Testifying
in Court
12 Hours
(30)
Dealing with Victims and the Public
4 Hours
(31)
Ethics of Professional Law
Enforcement
4 Hours
(32)
Testing
13 Hours
(33)
Physical Fitness
43 Hours
(c) The "Basic Law Enforcement Training Manual" as
published by the North Carolina Justice Academy is hereby
incorporated by reference, and shall automatically include
any later amendments and editions of the incorporated
material as provided by G.S. 150B-21.6, to apply as basic
curriculum for this basic training course for law enforce-
ment officers as administered by the Commission. Copies
of this publication may be inspected at the office of the
agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
and may be obtained for ninety-five dollars ($95.00) per
copy from the Academy at the following address:
North Carolina Justice Academy
Post Office Drawer 99
10:2
NORTH CAROLINA REGISTER
April 17, 1995
128
PROPOSED RULES
Salemburg, North Carolina 28385
(d) The "Basic Law Enforcement Training Course
Management Guide" as published by the North Carolina
Justice Academy is hereby incorporated by reference, and
shall automatically include any later amendments and
editions of the incorporated material as provided by G.S.
150B-21.6, to be used by certified school directors in
planning, implementing and delivering basic training
courses. Each certified school director shall be issued a
copy of the guide at the time of certification at no cost to
the accredited school. The public may obtain copies of this
guide from the Justice Academy for one dollar and sixty-
five cents ($1.65) per copy.
Total
160 Hours
(c) The "Basic Correction Officer Training Manual" as
published by the Department of Correction is hereby
adopted incorporated by reference, and shall automatically
include any later amendments and editions of the adopted
matter as authoriz e d by G.S. — 150B H(o) incorporated
material as provided by G.S. 150B-21.6 , to apply as the
basic curriculum for delivery of correctional officer basic
training courses.
(d) Commission-accredited schools that are accredited to
offer the "Basic Training: Correctional Officers" course are:
The Office of Staff Development and Training of the North
Carolina Department of Correction.
Statutory Authority G.S. 17C-6; 17C-10.
Statutory Authority G.S. 17C-6; 17C-10.
.0206 BASIC TRAINING - CORRECTIONAL
OFFICERS
(a) The basic training course for correctional officers
shall consist of a minimum of 160 hours of instruction
designed to provide the trainee with the skills and knowl-
edge to perform those tasks essential to function as a
correctional officer.
(b) Each basic training course for correctional officers
shall include the following identified topic areas and
minimum instructional hours for each area; however, the
director is authorized to permit modification of the topical
areas and minimum instructional hours, not inconsistent with
a minimum of 160 hours of instruction, on an interim basis
with such modifications to be submitted to the Standards
Committee and the full commission at their next regularly
scheduled meeting:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
The Division of Prisons Employee 2 Hours
Prison Security Functions and
Procedures 4
Contraband and Techniques of Search 8
Inmate Supervision 8
Firearms 24
Inmate Classification Process and
Programs 4
Understanding Inmate Behavior 12
Prison Emergency Operations 18
Radio Communications,
Transporting, and Restraints 4
Basic Life Support 12
Prison Health Services 2
Report Writing 6
You and the Law 4
Interpersonal Communication Skills 16
Unarmed Self Defense 18
Role of the Correctional Witness 4
Disciplinary and Inmate Grievance
Procedures 4 Hours
Administrative Matters, Review
and Testing 10 Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
Hours
.0210 RADAR INSTRUCTOR TRAINING COURSE
(a) The radar instructor training course required for radar
instructor certification shall consist of a minimum of 62
hours of instruction presented within a period not to exceed
six consecutive weeks.
(b) Each radar instructor training course shall be designed
to provide the trainee with the skills and knowledge to
proficiently perform the function of a criminal justice radar
instructor.
(c) Each applicant for radar instructor training shall:
(1) Present the endorsement of a commis-
sion-recognized school director or agency execu-
tive officer or his designee.
(2) Possess criminal justice general instructor certifi-
cation as required in 12 NCAC 9B .0302.
(d) Each radar instructor training course shall include but
not be limited to the following topic areas and corresponding
instructional hours and incorporate the corresponding
minimum trainee performance objectives within the course
curriculum:
(1) Course Orientation 2 Hours
(A) description of the course content;
(B) outline of the performance requirements for
successful completion of the radar instructor
training program.
(2) North Carolina Administrative Code: 2 Hours
Familiarization with the code as to radar training
courses and certification requirements, to include
completion of the forms that pertain to speed
measurement instrument training.
(3) Overview and Introduction to Radar
Training 4 Hours
(A) description of the objectives of a radar training
program;
(B) identification of specific requirements for radar
instructors, operators and equipment as set
forth in the Radar Reliability Act (G.S. 17C
and G.S. 8-50.2);
(4) Speed Offenses and Speed
Enforcement 6 Hours
(A) description in quantitative and qualitative terms
♦
129
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
the association between speed offenses and
motor vehicle accidents;
(B) description of major types of speed regula-
tions, including origin, development, and
scope of these regulations;
(C) description in quantitative and qualitative terms
the safety benefits of effective speed enforce-
ment in general and 55 mph in particular.
(5) Basic Principles of Radar Speed
Measurement 6 Hours
(A) description of the basic operating principles of
a stationary and moving radar instrument;
(B) explanation of the Doppler Principle in terms
of how a radar signal is changed by reflection
off a moving object;
(C) description of factors that can affect radar
accuracy and effectiveness.
(6) Legal and Operational Considerations 8 Hours
(A) identification and description of fundamental
case law affecting the use of radar for speed
measurement and enforcement;
(B) demonstration of basic skills in preparing and
presenting evidence and testimony concerning
speed enforcement and radar speed measure-
ment;
(C) description and application of required operat-
ing procedures of radar instruments.
(7) Classroom Familiarization with Specific Radar
Instruments: 8 Hours
demonstration of familiarity with the functions and
operating procedures of approved radar instru-
ments.
(8) Moot Court 6 Hours
(A) preparation of complete, concise and effective
direct testimony for radar cases;
(B) respond properly and effectively to cross
examination.
(9) Field Operation of Specific Radar
Instrument 8 Hours
(A) description of the functional components of
approved radar units;
(B) description of the setup, calibration, and
operation procedures of approved radar units;
(C) operation and performance of all procedural
requirements of actual patrol with approved
radar units.
(10) Motor-Skill Performance Testing: 8 Hours
(A) demonstration of the ability to successfully
setup, calibrate and operate approved radar
instruments for which the trainee seeks certifi-
cation in accordance with criteria specified on
a standardized trainee performance evaluation
form;
(B) demonstration of the ability to estimate vehicu-
lar speed in accordance with criteria specified
on a standardized trainee performance evalua-
tion form.
(11)
(12)
Course Review
Written Test
2 Hours
2 Hours
Total
62 Hours
(e) The "Radar Operator Training Course" as published
by the North Carolina Justice Academy is hereby adopt e d
incorporated by reference, and shall automatically include
any later amendments and editions of the adopted matter as
authoriz e d by G.S. 150B H(o) incorporated material as
provided by G.S. 150B-21.6 . to apply as basic curriculum
for the radar instructor training course for radar instructors
as administered by the Commission. Copies of this publica-
tion may be inspected at the office of the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
and may be obtained at cost at the address in this Rule.
(f) Commission-accredited schools that are accredited to
offer the "Radar Instructor Training Course" are: The
North Carolina Justice Academy.
Statutory Authority G.S. 17C-6.
.0212 CERTIFICATION TRAINING FOR RADAR
OPERATORS
(a) The radar operator training course for law enforce-
ment officers shall consist of a minimum of 32 hours of
instruction designed to provide the trainee with the skills and
knowledge to proficiently perform those tasks essential to
function as a radar operator. This course shall be for a
period not to exceed four consecutive weeks.
(b) Only employed or appointed personnel of a law
enforcement agency shall be enrolled in the radar operator
training course. Such a trainee shall not be certified as a
radar operator until the basic law enforcement training
course has been successfully completed and probationary or
general law enforcement certification has been granted.
Sheriffs, deputy sheriffs and federal law enforcement
personnel, including but not limited to armed forces person-
nel, shall be allowed to participate in radar operator training
courses on a space available basis at the discretion of the
school director without having enrolled in or having success-
fully completed the basic law enforcement training course
and without being currently certified in a probationary status
or hold general law enforcement certification.
(c) Each radar operator training course for law enforce-
ment officers shall include the following topic areas and
corresponding instructional hours and incorporate the
corresponding minimum trainee performance objectives
within the course curriculum:
(1) Course Orientation: 1 Hour
(A) description of the course content;
(B) outline of the performance requirements for
10:2
NORTH CAROLINA REGISTER
April 17, 1995
130
PROPOSED RULES
successful completion of the radar operator
training program.
(2) Speed Offenses and Speed
Measurement: 3 Hours
(A) description in quantitative and qualitative terms
the association between speed offenses and
motor vehicle accidents;
(B) description of major types of speed regula-
tions, including origin, development, and
scope of these regulations;
(C) description in quantitative and qualitative terms
the safety benefits of effective speed enforce-
ment in general.
(3) Basic Principles of Radar Speed
Measurement: 5 Hours
(A) description of the basic operating principles of
a stationary and moving radar instrument;
(B) explanation of the Doppler Principle in terms
of how a radar signal is changed by reflection
off a moving object;
(C) description of factors that can affect radar
accuracy and effectiveness.
(4) Legal and Operational Considerations: 4 Hours
(A) identification and description of fundamental
case law affecting the use of radar for speed
measurement and enforcement;
(B) demonstration of basic skills in preparing and
presenting evidence and testimony concerning
speed enforcement and radar speed measure-
ment;
(C) description and application of accepted operat-
ing procedures of radar instruments;
(D) demonstration of the ability to estimate vehicu-
lar speed in accordance with criteria specified
on a standardized trainee performance evalua-
tion form.
(5) Classroom Familiarization with Specific Radar
Instruments: 2 Hours
demonstration of familiarity with the functions
and operating procedures of radar instruments
for which the trainee seeks certification.
(6) Moot Court: 4 Hours
(A) preparation of complete, concise and effective
direct testimony for radar cases;
(B) respond properly and effectively to cross
examination
(7) Supervised/Monitored Practice with Specific
Radar Instruments: 6 Hours
(A) description of the functional components of the
radar units for which the trainee seeks certifi-
cation;
(B) description of the setup, calibration, and
operation procedures of the radar units for
which the trainee seeks certification;
(C) operation and performance of all procedural
requirements of actual patrol with the radar
units for which the trainee seeks certification.
(8) Motor-Skill Performance Testing: 4 Hours
(9)
(10)
demonstration of the ability to successfully
setup, calibrate and operate the radar instru-
ments for which the trainee seeks certification in
accordance with criteria specified on a standard-
ized trainee performance evaluation form.
Course Review 1 Hour
Written Test. 2 Hours
Total
32 Hours
(d) The "Radar Operator Training Course" as published
by the North Carolina Justice Academy is hereby adopted
incorporated by reference, and shall automatically include
any later amendments and editions of the adopted matter an
authoriz e d by G.S. 150B H(o) incorporated material as
provided by G.S. 150B-21.6 . to apply as basic curriculum
for the radar operator training course for radar operators as
administered by the Commission. Copies of this publication
may be inspected at the office of the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
and may be obtained at cost at the address in this Rule.
Statutory Authority G.S. 17C-6.
.0213 CERTIFICATION TRAINING FOR RADAR
TD/SMI OPERATORS
(a) Each radar and time-distance speed measurement
instrument operator training course for law enforcement
officers shall consist of a minimum of 48 hours of instruc-
tion designed to provide the trainee with the skills and
knowledge to proficiently perform those tasks essential to
function as a radar and time-distance speed measurement
instrument operator. This course shall be for a period not
to exceed four consecutive weeks.
(b) Only employed or appointed personnel of a law
enforcement agency may be enrolled in the radar and
time-distance speed measurement instrument operator
training course. Such a trainee shall not be certified as a
radar and time-distance speed measurement instrument
operator until the basic law enforcement training course has
been successfully completed and probationary or general law
enforcement certification has been granted. Sheriffs, deputy
sheriffs, and federal law enforcement personnel, including
but not limited to armed forces personnel, shall be allowed
to participate in radar and time-distance speed measurement
instrument operator training courses on a space available
basis at the discretion of the school director without having
enrolled in or having successfully completed the basic law
enforcement training course and without being currently
certified in a probationary status or holding general law
enforcement certification.
(c) Each combined radar and time-distance speed mea-
surement instrument operators' training course shall include
131
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
all topic areas specified in 12 NCAC 9B .0212(c). The
additional 16 instructional hours in the time-distance speed
measurement instrument operators' training course shall
include but not be limited to the following topic areas and
corresponding instructional hours and incorporate the
corresponding minimum trainee performance objectives
within the course curriculum:
(1) Basic Principles of Time-Distance Speed Mea-
surement Instruments: 1 Hour
(A) description of the basic principles on which
time-distance speed measurement instruments
operate;
(B) explanation of the procedures used in calibrat-
ing time-distance speed measurement instru-
ments;
(C) description of the basic operating procedures
required when employing time-distance speed
measurement instruments.
(2) Legal and Operational Considerations of
Tune-Distance Speed Measurement Instruments:
2 Hours
(A) identification and description of fundamental
case law affecting the use of time-distance
speed measurement for speed enforcement;
(B) identification and description of accepted
operating procedures for the proper use of
time-distance speed measurement instruments;
(C) identification and description of factors which
may affect the selection of various speed
measurement sites.
(3) Classroom Familiarization with Specific
Tune-Distance Speed Measurement Instruments:
2 Hours
demonstration of familiarity with the functions
and operating procedures time-distance speed
measurement instruments) for which the trainee
seeks certification.
(4) Moot Court: 2 Hours
(A) preparation of complete, concise and effective
direct testimony for time-distance speed mea-
surement instrument cases;
(B) respond properly and effectively to cross
examination.
(5) Supervised/Monitored Practice with Specific
Time-Distance Speed Measurement
Instruments: 5 Hours
(A) description of the functional components of the
time-distance speed measurement instrument(s)
for which the trainee seeks certification;
(B) description of the setup, calibration and opera-
tion procedures of the time-distance speed
measurement instrument(s) for which the
trainee seeks certification;
(C) operation and performance of all procedural
requirements of actual patrol with the
time-distance speed measurement instrument
for which the trainee seeks certification.
(6)
Motor-Skill Performance Testing: 4 Hours
demonstration of the ability to successfully
setup, calibrate and operate the time-distance
speed measurement instrument(s) for which the
trainee seeks certification in accordance with
criteria specified on a standardized trainee
performance evaluation form.
Total
16 Hours
(d) The "Time-Distance Operator Course" as published
by the North Carolina Justice Academy is hereby adopted
incorporated by reference, and shall automatically include
any later amendments and editions of the adopted matt e r a s
authorized by G.S. 150B 14(o) incorporated material as
provided by G.S. 150B-21.6 , to apply as basic curriculum
for the radar and time-distance speed measurement instru-
ment operator training course for radar and time-distance
speed measurement instrument operators as administered by
the Commission. Copies of this publication may be in-
spected at the office of the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
and may be obtained at cost at the address in this Rule.
Statutory Authority G.S. 17C-6.
.0214 CERTIFICATION TRAINING FOR TD/SMI
OPERATORS
(a) The time-distance speed measurement operator
training course for law enforcement officers shall consist of
a minimum of 32 hours of instruction designed to provide
the trainee with the skills and knowledge to proficiently
perform those tasks essential to function as a time-distance
speed measurement operator. This course shall not exceed
four consecutive weeks.
(b) Only employed or appointed personnel of a law
enforcement agency may be enrolled in the time-distance
speed measurement operator training course. Such a trainee
shall not be certified as a time-distance speed measurement
operator until the basic law enforcement training course has
been successfully completed and probationary or general law
enforcement certification has been granted. Sheriffs, deputy
sheriffs, and federal law enforcement personnel, including
but not limited to armed forces personnel, shall be allowed
to participate in time-distance speed measurement operator
training courses on a space available basis at the discretion
of the school director without having enrolled in or having
successfully completed the basic law enforcement training
course and without being currently certified in a probation-
ary status or holding general law enforcement certification.
(c) Each time-distance speed measurement instrument
operator training course for law enforcement officers shall
10:2
NORTH CAROLINA REGISTER
April 17, 1995
132
PROPOSED RULES
include the following topic areas and corresponding instruc-
tional hours and incorporate the corresponding minimum
student performance objectives within the course curricu-
lum:
(1) Course Orientation: 1 Hour
(A) description of the course content;
(B) outline of the performance requirements for
successful completion of the time-distance
speed measurement instrument operator train-
ing program.
(2) Speed Offenses and Speed
Measurement: 3 Hours
(A) description in quantitative and qualitative terms
the association between speed offenses and
motor vehicle accidents;
(B) description of major types of speed regula-
tions, including origin, development, and
scope of these regulations;
(C) description in quantitative and qualitative terms
the safety benefits of effective speed enforce-
ment in general.
(3) Basic Principles of Time-Distance Speed Mea-
surement: 2 Hours
(A) description of the basic operating principles of
electronic time-distance speed measurement
instruments;
(B) description of factors that can affect electronic
time-distance speed measurement instrument
accuracy and effectiveness.
(4) Legal and Operational Considerations: 4 Hours
(A) identification and description of fundamental
case law affecting the use of time-distance
speed measurement for speed enforcement;
(B) description and application of accepted operat-
ing procedures of time-distance speed measure-
ment instruments;
(C) demonstration of the ability to estimate vehicu-
lar speed in accordance with criteria specified
on a standardized trainee performance evalua-
tion form.
(5) Classroom Familiarization with Specific
Time-Distance Speed Measurement
Instruments: 2 Hours
demonstration of familiarity with the functions
and operating procedures of time-distance speed
measurement instruments for which the trainee
seeks certification.
(6) Moot Court: 4 Hours
(A) preparation of complete, concise and effective
direct testimony for time-distance speed mea-
surement cases;
(B) respond properly and effectively to cross
examination;
(C) demonstration of basic skills in preparing and
presenting evidence and testimony concerning
speed enforcement and time-distance speed
measurement.
(7) Supervised/Monitored Practice with Specific
Time-Distance Speed Measurement
Instruments: 8 Hours
(A) description of the functional components of the
time-distance speed measurement units for
which the trainee seeks certification;
(B) description of the setup, calibration, and
operation procedures of the time-distance
speed measurement units for which the trainee
seeks certification;
(C) operation and performance of all procedural
requirements of actual patrol with the
time-distance speed measurement units for
which the trainee seeks certification.
(8) Motor-Skill Performance Testing: 5 Hours
demonstration of the ability to successfully
setup, calibrate and operate the time-distance
speed measurement instruments for which the
trainee seeks certification in accordance with
criteria specified on a standardized trainee
performance evaluation form.
(9) Course Review 1 Hour
(10) Written Test 2 Hours
Total
32 Hours
(d) The "Time-Distance Operator Course" as published
by the North Carolina Justice Academy is hereby adopted
incorporated by reference, and shall automatically include
any later amendments and editions of the adopted matter as
authoriz e d by G.S. 150B M(o) incorporated material as
provided by G.S. 150B-21.6 , to apply as basic curriculum
for the time-distance speed measurement operator training
course for time-distance speed measurement operators as
administered by the Commission. Copies of this publication
may be inspected at the office of the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
and may be obtained at cost at the address in this Rule.
Statutory Authority G.S. 17C-6.
.0226 SPECIALIZED INSTRUCTOR TRAINING -
FIREARMS
(a) The instructor training course requirement for special-
ized firearms instructor certification shall consist of a
minimum of 83 hours of instruction presented during a
continuous period of not more than two weeks.
(b) Each specialized firearms instructor training course
shall be designed to provide the trainee with the skills and
knowledge to perform the function of a criminal justice
firearms instructor in a "Basic Recruit Training — Law
Enforcement" course or a "Law Enforcement Officers's
In-Service Firearms Training and Qualification Program".
(c) Each applicant for specialized firearms instructor
<
133
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
training shall:
(1) have completed the criminal justice general
instructor training course; and,
(2) present a written endorsement by a certified
school director indicating the student will be
utilized to instruct firearms in "Basic Recruit
Training— Law Enforcement" courses; or
(3) present a written endorsement by a department
head or certified school director indicating the
student will be utilized to instruct firearms in a
"Law Enforcement Officer's In-Service Firearms
Training and Qualification Program"; and,
(4) possess a current valid CPR Certification.
(d) Each specialized firearms instructor training course
shall include as a minimum the following identified topic
areas and minimum instructional hours for each area:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
Orientation/ Pretest
Range Operations
Civil Liability
Night Firing
Combat Shooting
Mental Conditioning
Shotgun Operation and Firing
8 Hours
38 Hours
4 Hours
2 Hours
8 Hours
1 Hour
4 Hours
Service Handgun - Operation and Use 5 Hours
Rifle - Operation and Maintenance 4 Hours
Service Handgun - Maintenance and
Cleaning 2 Hours
Range Medical Emergencies 2 Hours
In-Service Firearms Requirements 2 Hours
BLET Lesson Plan Review/Post Test 3 Hours
(e) The "Specialized Firearms Instructor Training Man-
ual" as published by the North Carolina Justice Academy is
hereby adopted incorporated by reference, and shall auto-
matically include any later amendments and editions of the
adopted matter a s authorized by G.S. 150B 1 4 (c) incorpo-
rated material as provided by G.S. 150B-21.6 . to apply as
the basic curriculum for delivery of specialized firearms
instructor training courses. Copies of this publication may
be inspected at the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
(f) Commission-accredited schools that are accredited to
offer the "Specialized Instructor Training - Firearms" course
are: The North Carolina Justice Academy.
Statutory Authority G.S. 17C-6.
(2)
(3)
(4)
(5)
35 hours of instruction presented during a continuous period
of not more than one week.
(b) Each specialized driver instructor training course shall
be designed to provide the trainee with the skills and
knowledge to perform the function of a criminal justice
driver instructor in a "Basic Recruit Training - Law En-
forcement" course.
(c) Each applicant for specialized driver instructor
training shall:
(1) have completed the criminal justice general
instructor training course;
present a written endorsement by a certified
school director indicating the student will be
utilized to instruct driving in "Basic Recruit
Training— Law Enforcement" courses;
possess a valid operator driver's license;
maintain a safe driving record where no more
than four points have been assigned against the
driving record within the past three years; and,
possess a current valid CPR Certification.
(d) Each specialized driver instructor training course shall
include as a minimum the following identified topic areas
and minimum instructional hours for each area:
(1) Orientation
(2) Lesson Plan Review (BLET)
(3) General Mechanical Knowledge
(4) Before - Operation Inspection
(5) Laws of Natural Force &
Operating Characteristics
(6) Driver Practicum
(7) Fundamentals of Professional
Liability for Trainers
(8) Course Review/State Exam
(e) The "Specialized Driver Instructor Training Manual"
as published by the North Carolina Justice Academy is
hereby adopted incorporated by reference, and shall auto-
matically include any later amendments and editions of the
adopt e d matt e r ao authoriz e d by G.S. 150B M(o) incorpo-
rated material as provided by G.S. 150B-21.6 . to apply as
the basic curriculum for delivery of specialized driver
instructor training courses. Copies of this publication may
be inspected at the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
(f) Commission-accredited schools that are accredited to
offer the "Specialized Instructor Training - Driving" course
are: The North Carolina Justice Academy and The North
Carolina State Highway Patrol .
1 Hour
4 Hours
2 Hours
1 Hour
4 Hours
6 Hours
4 Hours
3 Hours
.0227 SPECIALIZED INSTRUCTOR TRAINING -
DRIVING
(a) The instructor training course required for specialized
driver instructor certification shall consist of a minimum of
Statutory Authority G.S. 17C-6.
10:2
NORTH CAROLINA REGISTER
April 17, 1995
134
PROPOSED RULES
.0228 BASIC TRAINING - WILDLIFE
ENFORCEMENT OFFICERS
(a) The basic training course for wildlife enforcement
officers appointed by the Wildlife Resources Commission as
authorized under General Statute 113-136 shall consist of a
minimum of 556 hours of instruction designed to provide
the trainee with the skills and knowledge to perform those
tasks essential to function as a wildlife enforcement officer.
(b) Each basic training course for wildlife enforcement
officers shall include the following identified topical areas
and minimum instructional hours for each area:
2 Hours
8 Hours
6 Hours
2 Hours
60 Hours
as published by
Commission is
and shall auto-
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(ID
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
(26)
(27)
(28)
(29)
(30)
(31)
(32)
(33)
(34)
(35)
(36)
Course Orientation 2 Hours
Constitutional Law 4 Hours
Laws of Arrest, Search and
Detention 16 Hours
Mechanics of Arrest, Arrest
Procedures 8 Hours
Law Enforcement Communications
and Information System 4 Hours
Elements of Criminal Law 24 Hours
Defensive Tactics 32 Hours
Juvenile Law and Procedures 8 Hours
First Responder 40 Hours
Firearms 40 Hours
Hunter Safety 10 Hours
Patrol Techniques 16 Hours
Field Notetaking and Report Writing 12 Hours
Crisis Management 10 Hours
Criminal Investigation 12 Hours
Interviews; Field and In-Custody 8 Hours
Controlled Substances 6 Hours
ABC Laws and Procedures 4 Hours
Electrical and Hazardous Materials
Emergencies 12 Hours
Law Enforcement Drivers Training 40 Hours
Preparing for Court and Testifying
in Court 12 Hours
Game and Fish Laws 36 Hours
Motorboat Laws 12 Hours
Boating Procedures & Small Boat
Handling 20 Hours
Dealing with Problem Animal
Situations 4 Hours
Basic Field Identification of Fishes 6 Hours
Basic Field Identification of Game Animals,
Game Birds and Non-Game Animals 2 Hours
Identification of Migratory Waterfowl 2 Hours
Endangered Species 2 Hours
Trapping 8 Hours
Water Safety and Swimming 16 Hours
Knotsmanship, A Practical Use of
Rope 2 Hours
Wildlife Law Enforcement and the
Media 8 Hours
Motorboat Accident Investigation 12 Hours
Civil Disorders 12 Hours
Radiological Monitoring 16 Hours
(37) Covert Activities
(38) Basic Photography
(39) Motor Vehicle Laws
(40) DWI Enforcement
(41) Physical Training
(c) The "Wildlife Basic Training Manual"
the North Carolina Wildlife Resources
hereby adopted incorporated by reference,
matically include any later amendments and editions of the
adopted matter ao authorized by G.S. 150B 14(o) incorpo-
rated material as provided by G.S. 150B-21.6 . to apply as
the basic curriculum for delivery of wildlife enforcement
officer basic training courses.
(d) Commission-accredited schools that are accredited to
offer the "Basic Training: Wildlife Enforcement Officers"
course are: The Division of Enforcement Training Office
of the North Carolina Wildlife Resources Commission.
Statutory Authority G.S. 17C-6; 17C-10.
.0232 SPECIALIZED INSTRUCTOR TRAINING -
DEFENSIVE TACTICS
(a) The instructor training course required for specialized
defensive tactics instructor certification shall consist of a
minimum of 40 hours of instruction presented during a
continuous period of not more than one week.
(b) Each specialized defensive tactics instructor training
course shall be designed to provide the trainee with the
skills and knowledge to perform the function of a criminal
justice defensive tactics instructor in a "Basic Recruit
Training—Law Enforcement" course.
(c) Each applicant for specialized defensive tactics
instructor training shall:
(1) have completed the criminal justice general
instructor training course;
(2) present a letter from a licensed physician stating
the applicant's physical fitness to participate in
the course;
(3) present a written endorsement by a certified
school director indicating the student will be
utilized to instruct defensive tactics in "Basic
Recruit Training—Law Enforcement" courses;
and,
(4) possess a current valid CPR Certification.
(d) Each specialized defensive tactics instructor training
course shall include as a minimum the following identified
topic areas and minimum instructional hours for each area:
(1) Orientation/Pretest 4 Hours
(2) Civil Liability 4 Hours
(3) Response to Injury 4 Hours
(4) Safety Rules 2 Hours
(5) Lesson Plan Review (BLET) 2 Hours
(6) Defensive Tactics Instructional
Methods 24 Hours
(e) The "Specialized Defensive Tactics Instructor Training
Manual" as published by the North Carolina Justice Acad-
emy is hereby adopted incorporated by reference, and shall
automatically include any later amendments and editions of
♦
135
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
the adopted matter as authorized by G.S. — 150B 1 4 (c)
incorporated material as provided by G.S. 150B-21.6 , to
apply as the basic curriculum for delivery of specialized
defensive tactics instructor training courses. Copies of this
publication may be inspected at the agency:
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
(f) Commission-accredited schools that are accredited to
offer the "Specialized Instructor Training - Defensive
Tactics" course are: The North Carolina Justice Academy.
Statutory Authority G.S. 17C-6.
.0233 SPECIALIZED INSTRUCTOR TRAINING -
PHYSICAL FITNESS
(a) The instructor training course required for specialized
physical fitness instructor certification shall consist of a
minimum of 40 hours of instruction presented during a
continuous period of not more than one week.
(b) Each specialized physical fitness instructor training
course shall be designed to provide the trainee with the
skills and knowledge to perform the function of a criminal
justice physical fitness instructor in a "Basic Recruit
Training — Law Enforcement" Course.
(c) Each applicant for specialized physical fitness training
shall:
(1) qualify through one of the following three
options:
(A) have completed the criminal justice general
instructor training course; or
(B) hold a current and valid North Carolina
Teacher's Certificate and hold a minimum of
a baccalaureate degree in physical education
and be actively teaching in physical education
topics; or
(C) be presently instructing physical education
topics in a community college, college or
university and hold a minimum of a baccalau-
reate degree in physical education; and
(2) present a written endorsement by a certified
school director indicating the student will be
utilized to instruct physical fitness in "Basic
Recruit Training — Law Enforcement" courses;
and
(3) present a letter from a physician stating fitness
to participate in the course; and,
(4) possess a current valid CPR Certification.
(d) Each specialized physical fitness instructor training
course shall include as a minimum the following identified
topic areas and minimum instructional hours for each area:
(1) Orientation 1 Hour
(2) Lesson Plan Review 2 Hours
(3) Physical Fitness Assessments,
Exercise Programs and Instructional
Methods 26 Hours
(4) Injury Care and Prevention 3 Hours
(5) Nutrition 3 Hours
(6) Civil Liabilities for Trainers 3 Hours
(7) Examination 2 Hours
(e) The "Physical Fitness Instructor Training Manual" as
published by the North Carolina Justice Academy is hereby
adopted incorporated by reference, and shall automatically
include any later amendments and editions of the adopt e d
matter as authoriz e d by G.S. — 1S0B 14(o) incorporated
material as provided by G.S. 150B-21.6 , to apply as the
basic curriculum for delivery of specialized physical fitness
instructor training courses. Copies of this publication may
be inspected at the agency.
Criminal Justice Standards Division
North Carolina Department of Justice
1 West Morgan Street
Court of Appeals Building
Post Office Drawer 149
Raleigh, North Carolina 27602
(f) Commission-accredited schools that are accredited to
offer the "Specialized Instructor Training — Physical
Fitness" course are: The North Carolina Justice Academy.
Statutory Authority G.S. 17C-6.
SUBCHAPTER 9C - ADMINISTRATION OF
CRIMINAL JUSTICE EDUCATION AND
TRAINING STANDARDS
SECTION .0400 - ACCREDITATION OF
CRIMINAL JUSTICE SCHOOLS AND
TRAINING COURSES
.0401 ACCREDITATION OF CRIMINAL JUSTICE
SCHOOLS
(a) Any oohool m ee ting th e minimum roquirem e nto
oontninod in 12 NCAC 9 - B .0200 and submitting a prop e rly
completed Request — for School Accreditation — shall bo
accredited — to provide criminal justice training courses.
Accr e ditation of a s chool shall r e main e ff e ctiv e for two
y e ars from ioonano e unl e ss e arli e r susp e nded or revoked The
Commission shall establish a standing subcommittee of the
Education and Training Committee for the purposes of
evaluating Request for School Accreditation applications and
making recommendations to the Education and Training
committee on the granting of accreditation to institutions and
agencies. The Accreditation Committee shall be comprised
of two members appointed by the School Directors' Advi-
sory Committee and two members who shall be commission
members to include the North Carolina De partment of
Community Colleges' representative to the Commission.
The Chairman of the Commission shall a ppoint the Chair-
man of the Accreditation Committee .
(b) Any existing Commission-issued accreditations issued
and valid on January 1± 1996 are automatically extended
10:2
NORTH CAROLINA REGISTER
April 17, 1995
136
PROPOSED RULES
with an expiration date of December 31. 1996. Previously
issued accreditations with established expiration dates
extending beyond December 31. 1996 are declared to be
terminated and void on and after December 31. 1996. All
new applicants for school accreditation shall meet the
requirements of this section after January l± 1996.
(c) A sohool may r e new its accreditation biennially by
submitting an updated Request fo f School Accreditation.
Any school meeting the minimum requirements contained in
J_2 NCAC 9B .0200 must submit a properly completed
Request for School Accreditation application. Upon receipt
of a properly completed Request for School Accreditation
application;
(1) The Standards Division staff shall review the
application for any omissions and clarifications
and conduct a site visit to tour facilities, confirm
information on the a pplication, and determine if
and where deficiencies exist;
(2) The a pplying institution or agency shall be
contacted concerning deficiencies and assistance
shall be given on correcting problem areas;
(3) The application and staff reports are submitted
to the Accreditation Committee for review;
(4) A recommendation shall be submitted to the
Education and Training Committee on the ap-
proval or denial of the application; and
(5) The Education and Training Committee shall
recommend to the full Commission at its next
regularly scheduled meeting the a pproval or
denial of accreditation for the applicant institu-
tion or agency.
(d) Accreditation of a school shall remain effective for
five years from issuance unless earlier suspended or revoked
for just cause.
(e)(b) The identity of those schools accredited under this
Rule shall be published and distributed annually by the
Standards Division together with the name and business
address of the school director and the schedule of criminal
justice training courses planned for delivery during the
succeeding year.
(f) A school may apply for reaccreditation to the Com-
mission by submitting a properly completed Request for
School Accreditation application. The a pplication for
reaccreditation shall contain information on major changes
in facilities, equipment, and staffing. Upon receipt of a
properly completed application;
(1) The Standards Division staff shall review the
a pplication for any omissions and clarification;
(2) Copies of the site visits conducted during the last
period of certification shall be attached to the
a pplication;
(3) The application and staff reports shall be submit-
ted to the Accreditation Committee for review;
(4) A recommendation shall be submitted to the
Education and Training Committee on the ap-
proval or denial of the a pplication:
(5) The Education and Training Committee shall
recommend to the full Commission at its next
regularly scheduled meeting the a pproval or
denial of accreditation of the a ppi'cant institution
or agency.
(g) In instances where accredited schools have been found
to be in compliance with 1_2 NCAC 9B .0200 through
favorable site visit reports. Standards Division staff shall be
authorized to reaccredit on behalf of the Commission. Such
action shall be reported to the Commission through the
Accreditation Committee and the Education and Training
Committee at its next scheduled meeting.
£h}(d) The Commission may suspend or revoke a school's
accreditation when it finds that the school has failed to meet
or continuously maintain any requirement, standard, or
procedure for school or course accreditation.
Statutory Authority G.S. 17C-6.
SECTION .0600 - EQUIPMENT AND PROCEDURES
.0601 APPROVED SPEED-MEASURING INSTRUMENTS
(a-) — Th e following ppeed moaouring inotrum e nto ar e approv e d for radio miorowav e (radar) uoo, provided they or e not
equipped with dual antenn as^-
(43)-
rep e al e d
r e p e al e d
(3) repeal od
(4) repealed
(#} rep e al e d
(6) rep e al e d
(7) repealed
(8) repeal od
(9} r e p e al e d
(40) r e p e al e d
(44) repealed
Kustom HR 8
Kuotom HR 12
Stationary
Moving/Stationary
137
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
(44) ropoalod
(45) repeal e d
(464-
&&-
Kuotom KR 1 1
MPH K IS
MPH K 55
MPH S 80
(494-
(30) repeal e d
(34) repeal e d
Dooatur Ra Gun (RAS & "N" Series)
(35) repeal e d
Dooatur Ra Gun 1 and 3 (RAS) (Inoludod in No. 33)
Kustom KR 10 SP
(344-
(354-
(36) ropoalod
(3?) repeal e d
(3*4-
Kuotom Faloon
(39) Kustom Roadrunnor
(30) Kustom Trooper
Dooatur MVR 715
Dooatur MVR 731
Dooatur Hunter
@3)
(34) Kustom PRO 1000
(35) MPH K15 H (86)
(36) Appli e d Cono e pto Stalk e r
(3?) Dooatur Gonooio
Moving/Stationary
Stationary
Moving/Stationary
Moving/Stationary
Stationary
Moving/Stationary
Stationary
Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/ S tationary
Stationary
Moving/Stationary
Moving/Stationary
(a) The following speed-measuring instruments are approved for radio microwave (RADAR) use, provided they
operated with a single antenna:
Model Mode
are
Manufacturer
ill
Kustom Signals, Inc.
(2)
Kustom Signals, Inc.
01
Kustom Signals. Inc.
(4}
MPH Industries, Inc.
{5}
MPH Industries, Inc.
m
MPH Industries, Inc.
hi
Decatur Electronics, Inc.
m
Kustom Signals, Inc.
£9}
Kustom Signals. Inc.
(10)
Kustom Signals, Inc.
0JQ
Kustom Signals, Inc.
(12)
Decatur Electronics, Inc.
(13)
Decatur Electronics, Inc.
(14)
Kustom Signals, Inc.
(15)
MPH Industries. Inc.
(16)
Applied Concepts, Inc.
(17)
Decatur Electronics, Inc.
(18)
Applied Concepts. Inc.
(19)
Applied Concepts, Inc.
(20)
Applied Concepts, Inc.
(21)
Kustom Signals, Inc.
(22)
Kustom Signals, Inc.
(23)
Kustom Signals, Inc.
(24)
Kustom Signals, Inc.
(25)
M.P.H. Industries, Inc.
HR-8
HR-12
KR-11
K-15
K-55
S-80
Ra-Gun
KR-10 SP
Falcon
Roadrunner
Trooper
MVR
Hunter
Pro- 1000
K-15 H
Stalker ATR
Genesis I
Stalker ATR
Stalker DUAL
Stalker DUAL SL
Eagle
Eagle; Plus
Eagle; Silver
Eagle; Golden
BEE-36
Stationary
Moving/Stationary
Moving/Stationary
Stationary
Moving/Stationary
Moving/Stationary
Stationary
Moving/Stationary
Stationary
Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Stationary
Moving/Stationary
Moving/Stationary
Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
Moving/Stationary
(b) The following spood measuring instruments are approved for time distance use provided that the instrument i s not capable
of aooopting doublo time or doublo distance into the computer!
10:2
NORTH CAROLINA REGISTER
April 17, 1995
138
PROPOSED RULES
ft) ropoalod
(2) rep e al e d
£J) repeal e d
(4) ropoalod
(5) Vascar Plus
Troffio Safety Syotomo, he-
rb) The following speed-measuring instruments are a pproved for time-distance use:
Manufacturer Model
Mode
(1) Traffic Safety Systems, Inc.
VASCAR-plus
Moving/Stationary
(c) All approved models and types of radio microwave (radar) speed-measuring instruments are made subject to and
restricted as follows:
(1) The automatic operate functions have been disconnected.
(2) The automatic alarms, audio and visual have been disconnected.
(3) The automatic locking functions have been disconnected.
(4) The instrument does not provide an external control that would permit the adjustment or correction of the zero
or calibration readings.
(5) The "High Speed Lock" function has been disconnected.
Note: The automatic functions that shall be disconnected are any and all automatic violation alarm or lock
capabilities that occur prior to the speed measuring instrument being manually locked by the operator.
(d) All radar speed measuring instruments, as herein defined, purchased on or after July 1, 1982 for speed enforcement
shall meet or exceed performance specifications as provided in the "Model Performance Specifications for Police Traffic
Radar Devices" as prepared by the Law Enforcement Standards Laboratory of the National Bureau of Standards and
published by the National Highway Traffic Safety Administration, United States Department of Transportation (as in effect
July 1, 1982) incorporated by reference herein and including any later amendments and editions as provided for in G.S.
150B-21.6. Copies of the document in this Rule are available from the agency address at the cost of three dollars and
seventy-five cents ($3.75) per copy.
(e) Prior to inclusion as an approved radar speed measuring instrument, the manufacturer of said instrument shall certify
in writing to the agency that said instrument meets or exceeds the standards of 12 NCAC 9C .0601(d) and provide a copy
of a testing report or other document illustrating the method and results used in such certification.
Statutory Authority G. S. 1 7C-6.
SUBCHAPTER 9D - PROFESSIONAL
CERTIFICATE PROGRAMS
SECTION .0100 - LAW ENFORCEMENT
OFFICERS' PROFESSIONAL CERTIFICATE £4}
.0102 GENERAL PROVISIONS
(a) In order to be eligible for one or more of the profes-
sional awards, an officer shall first meet the following
preliminary qualifications , oxoopt as provided for in 12
NCAC 9D ■0102(a)('1) :
(1) The officer shall presently hold general law
enforcement officer certification. A person
serving under a probationary certification is not
eligible for consideration.
(2) The officer shall be familiar with and subscribe
to the Law Enforcement Code of Ethics.
(3) The officer shall be a full-time, sworn, paid
member of a law enforcement agency within the (5)
state.
(4) Applicants who booamo full timo, sworn, paid
members of a law enforcement agoncy prior to
October 1, — 19 84 , shall bo evaluated under
criteria in existence on April 30, 19 86 . — : ¥h&%
oriteria shall be appli e d for a p e riod of tim e not
to exceed Deoomb e r 31, 1990.
(5)Effootivo May 1, 19 8 6, all All applicants who
become became full-time, sworn, paid members
of a law enforcement agency within the state on
or after October 1, 1984, shall be given credit
for satisfactory completion of only one commis-
sion-accredited basic training program for pur-
poses of calculating training points. Furth e r
mor e , in addition to mooting the qualifications
sot forth in this Rule, those applicants shall also
have acquired the combination of educational
points or degrees, — law enforcement training
points and y e ars of full tim e law e nforc e m e nt
experience — as — outlined — » — Rules — .0103,
■010 4 (a)(2), or .0105(a)(2) of this Section.
(6) Full-time, paid employees of a law enforce-
ment agency within the State who have success-
fully completed a commission-accredited law
enforcement officer basic training program and
139
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
have previously held general law enforcement
officer certification as specified in 12 NCAC 9D
.0102(a)(1), but are presently, by virtue of
promotion or transfer, serving in non sworn
positions not subject to certification are eligible
to participate in the professional certificate
program. Eligibility for this exception requires
continuous employment with the law enforce-
ment agency from the date of promotion or
transfer from a sworn, certified position to the
date of application for a professional certificate.
(b) Awards are based upon a formula which combines
formal education, law enforcement training, and actual
experience as a law enforcement officer. Points are
computed in the following manner:
(1) Each semester hour of college credit shall equal
one point and each quarter hour shall equal
two-thirds of a point;
(2) Twenty classroom hours of commis-
sion-approved law enforcement training shall
equal one point;
(3) Only experience as a full-time, sworn, paid
member of a law enforcement agency or equiva-
lent experience shall be acceptable for consider-
ation.
(c) Certificates will be awarded in an officer's area of
expertise only. Separate sub-programs will be administered
as follows:
(1) General Law Enforcement Certificate. The
General Law Enforcement Certificate is appro-
priate for full-time, sworn law enforcement
officers employed by units of local government
with authority to arrest for any violation of the
criminal law and to arrest anywhere within the
boundaries of the unit, including:
(A) municipal and county police officers,
(B) local ABC board enforcement officers.
(2) State Law Enforcement Certificate. The State
Law Enforcement Certificate is appropriate for
full-time, sworn law enforcement officers em-
ployed by an agency of state government, with
authority to arrest throughout the state, includ-
ing:
(A) Special agents of the State Bureau of Investiga-
tion,
(B) State Highway Patrol officers,
(C) State Alcohol Law Enforcement officers,
(D) lioono e and th e ft Division of Motor Vehicles
officers,
(E) Fisheries enforcement officers,
(F) Wildlife enforcement officers, and
(G) State forest rangers.
(3) Special Law Enforcement Certificate. The
Special Law Enforcement Certificate is appropri-
ate for other full-time, sworn law enforcement
officers with arrest authority, including:
(A) Security officers for State buildings and agen-
cies,
(B) Airport security officers,
(C) Campus police officers,
(D) Company police officers,
(E) Department of Correction extradition officers,
and
(F) Parks and recreation commissions enforcement
officers.
(d) There shall be limited reciprocity between
sub-programs. Only training and/or experience gained in an
officer's area of expertise will be eligible for application to
the sub-program.
Statutory Authority G.S. 17C-6.
.0104 INTERMEDIATE LAW ENFORCEMENT CERTIFICATE
(a) In addition to the qualifications set forth in Rule .0102(a) of this Subchapter, an applicant for the Intermediate Law
Enforcement Certificate shall possess or be eligible to possess the Basic Law Enforcement Certificate and shall have acquired
the following combination of educational points or degrees, law enforcement training points and years of full-time law
enforcement experience:
(4) The following standard will bo applied in evaluating applicants pursuant to Rule .0102(a)( 4 ) of this Section:
Eduoational Dogrooo
AA/AS
AB/BS
Years of Law
Enforcement Experience
Minimum Law
Enforcement Training
Points
45-
44
Minimum Total
Education and Training
Points
-30-
-60-
-90-
45-
44
10:2
NORTH CAROLINA REGISTER
April 17, 1995
140
PROPOSED RULES
(2) The following standard will bo applied in evaluating applicants pursuant to Rule .0102(a)(5) of this Section:
Educational Degrees AA/AS AB/BS
Years of Law
Enforcement Experience
Minimum Law
Enforcement Training
Points
8
22
21
Minimum Total
Education and Training
Points
37
67
97
22
21
(b) Educational points claimed shall have been earned at a technical institute, technical college, community college, junior
college, college or university accredited as such by the Department of Education of the state in which the institution is
located, the appropriate recognized accrediting body, or the state university of the state in which the institution is located.
Statutory Authority G.S. 17C-6.
.0105 ADVANCED LAW ENFORCEMENT CERTIFICATE
(a) In addition to the qualifications set forth in Rule .0102(a) of this Subchapter, an applicant for the Advanced Law
Enforcement Certificate shall possess or be eligible to possess the Intermediate Law Enforcement Certificate and shall have
acquired the following combination of educational points or degrees, law enforcement training points and years of full-time
law enforcement experience:
ft) The following standard will be appli e d in e valuating applicants purouant to Rul e .0201(a)Cl) of this S e ction:
Educational Degrees
Y e ars of Law
Enforcement Experience
Minimum Law
Enforc e m e nt Training
Points
42-
AAMS
AB/BS
GRAD./PRO .
-34-
48-
44
Minimum Total
Educat i on and Training
Points
-60-
-90-
-24-
48-
44
(3) Th e following standard will b e appli e d in evaluating applicants purouant to Rul e .0102(a)(5) of this S e otion:
Educational Degrees
Years of Law
Enforcement Experience
Minimum Law
Enforcement Training
Points
12
AA/AS
31
AB/BS
25
GRAD./PRO.
21
Minimum Total
Education and Training
Points
67
97
31
25
21
(b) Educational points claimed shall have been earned at a technical institute, technical college, community college, junior
college, college or university accredited as such by the Department of Education of the state in which the institution is
141
NORTH CAROLINA REGISTER
April 17, 1995
10.2
PROPOSED RULES
located, the recognized national accrediting body, or the state university of the state in which the institution is located.
Statutory Authority G.S. 17C-6.
.0106 METHOD OF APPLICATION
(a) All applicants for an award of the basic, intermediate
or advanced certificates in each sub-program shall complete
an "Application for Award of Law Enforcement Certifi-
cate. "
(b) Documentation of education and training shall be
provided by certified copies of transcripts, diplomas, Report
of Training Course Completion, agency training records, or
other verifying documents attached to the application.
(c) The applicant shall submit the Application for Award
of Law Enforcement Certificate to his the department head
who shall attach hw a recommendation and forward the
application to the Commission. Certificates will be issued
to the ©department head for award to the applicant.
(d) Certificates and awards remain the property of the
Commission and the Commission shall have the power to
cancel or recall any certificate or award.
Statutory Authority G.S. 17C-6.
TITLE 13
DEPARTMENT OF
LABOR
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Department of
Labor intends to amend rules cited as 13 NCAC 12 .0101,
.0303, .0307 -.0309, .0501; adopt 12 .0304 - .0306, .0310
- .0315, .0803 - .0808; and repeal 12 .0502.
Proposed Effective Date: August 1, 1995.
A Public Hearing will be conducted at 10:00 a.m. on
Friday, June 2, 1995 at the Agriculture Building, Room 359,
2 W. Edenton Street, Raleigh, NC 27601.
Reason for Proposed Action: To update the Wage and
Hour regulations. As part of the process of revising these
rules, the Department proposes a rearrangement of the rule
numbers in certain sections. This proposal is made for
purposes of clarifying the rules.
Comment Procedures: Please submit your comments to Mr.
Scott Templeton, APA Coordinator, NC Department of
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX:
(919) 715-5629; telephone: (919) 733-0368 by June 2, 1995.
You may present written or oral comments at the hearing;
however, time limits may be imposed by the chair.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
CHAPTER 12 - WAGE AND HOUR
SECTION .0100 - GENERAL PROVISIONS
.0101 WAGE AND HOUR DIVISION
The main office of the Wage and Hour Division, which
administers the provisions of Article 2A of G.S. Chapter 95,
is maintained in the Raloigh office of the Department of
Labor at 4 West Edenton Street, 413 N. Salisbury Street.
Raleigh, North Carolina 27601 27603 . The Division
maintains a branch offio e o office at 20 South Spruc e Street,
Ashovillo, — North — Carolina; — 1-+5 — Broad foot — Avenue,
Fayottovillo, North Carolina; and 500 West Trade Street,
Charlotte, North Carolina where it also receives public
inquiries and complaints. Other field offices are maintained
throughout the state where meetings may be arrang ed by
appointment. The Division's mailing address is:
Wage and Hour Division
North Carolina Department of Labor
4 West Edenton Street 413 N. Salisbury St.
Raleigh, North Carolina 27601 27603
919/733-2152.
Statutory Authority G.S. 95-25.17.
SECTION .0300 - WAGES
.0303 CERTIFICATION OF TffS
(a) For the purpose of counting tips as wages pursuant to
G.S. 95-25. 3(f), acceptance of wages from the employer
does not constitute certification by the employee of tips
received.
(b) An employer must maintain accurate and complete
records of each employee's tips, whether received individu-
ally or as part of a tip pooling arrangement. Individual
contributions and resulting shares of any tip pooling must
shall be recorded. In addition, an employer's records mast
shall show the amount claimed as a tip credit for each
employee for each workweek. If the amount claimed as a
credit cannot be calculated from the records for any work-
week, the employer «ay- shall not count the tips as wages.
(c) If an employer maintains the required records of each
employee's tips, obtaining the signature or initials of the
employees monthly or for each pay period constitutes
certification by the employees and these tips wiH shall be
counted as wages pursuant to G.S. 95-25. 3(f).
(d) This Section applies only to tipped employees who do
not participate in a ti p pooling arrangement. If the tipped
employee refuses to certify tips accurately and completely,
tips may still be counted as wages when the employer
complies with the provisions of G.S. 95-25. 3(f) and can
demonstrate by showing timely written documentation that
a tipped employee regularly receives tips in the amount for
10:2
NORTH CAROLINA REGISTER
April 17, 1995
142
PROPOSED RULES
which the tip credit is taken. While no particular form of
written documentation is required, it is sufficient for a
tipped employee to certify tips in the amount for which the
tip credit is taken or for the employer to show that a tipped
employee similarly situated certifies that he or she regularly
receives tips in the amount for which the tip credit was
taken. Such certification shall be made each pay period or
month.
(e) If tipped employees are participating in a tip. pooling
arrangement, the employer is required under all circum-
stances to keep accurate and complete records of tips
received by each employee participating in the tip pooling
arrangement.
Statutory Authority G.S. 95-25.3; 95-15; 95-19.
.0304 EMPLOYER ADDED SERVICE CHARGES
AND GRATUITIES
(a) Service charges included by the employer in the
charge to the customer constitute amounts due the business
and are not tips within the meaning of the term as defined
in G.S. 95-25.2(15). An employer's retention of all or part
of such a service charge shall not, unless otherwise prom-
ised, violate the requirement of G.S. 95-25.6 to pay all
wages and tips accruing to the employee, nor shall such
retention invalidate an otherwise valid tip credit arrange-
ment.
(b) A gratuity added by the employer to the charge to the
customer is a tip, which, absent an agreement to the
contrary, belongs the employee.
Statutory Authority G.S. 95-25.2(15); 95-25.6; 95-25.19.
.0305 TIPS CHARGED ON CREDIT CARDS
(a) Where tips are charged on credit cards, employers
may retain from the tips an amount up to or equal to the pro
rata portion of the fee charged by the credit card company
that is attributable to the tips. When employers make such
retentions, they do so without violating G.S. 95-25.6 and
without becoming disqualified from claiming the tip credit
on the charged tip because the tipped employee has not been
allowed to retain all tips pursuant to G.S. 95-25.3(f).
(b) Where tips are part of the employee's compensation,
tips charged on credit or charge cards accrue to the em-
ployee at the time they are charged and shall be paid on or
before the payday of the pay period in which they are
charged.
Statutory Authority G.S. 95-25.3; 95-25.6; 95-25.19.
.0306 TIP POOLING
(a) In a ti p pooling arrangement, for the purposes of G.S.
95-25.6 'tips accruing to the employee" shall mean either
the employee's share of the tip pool or 85% of the em-
ployee's tips before they were pooled, whichever is greater.
(b) When an employer allows a tipped employee, who is
participating in a tig pooling arrangement, to retain the
amount specified in Paragraph (a) of this Rule, the employer
has satisfied the provision under G.S. 95-25.3(0 requiring
the employer to allow the tipped employee to retain all tips.
(c) An employer shall give each employee who is re-
quired to participate in a tip pooling arrangement advance
notice of the arrangement in accordance with G.S. 95-25.13.
Employees not so notified are not subject to the tin. pooling
arrangement, unless they otherwise agree to iL
(d) Only those employees who are employed in occupa-
tions that customarily and regularly receive tips may share
in a tirj pooling arrangement. Examples of such occupations
include waiters, waitresses, bellhops, busboys/girls. and
bartenders. Examples of occupations that shall not partici-
pate in tip pooling arrangements include janitors, dishwash-
ers, chefs and cooks.
Statutory Authority G.S. 95-25. 3(f); 95-25.6; 95-25.13; 95-
25. 19.
.0307 t«3«5 AUTHORIZATION FOR WITHHOLDING
OF WAGES
(a) An authorization by an employee which will allow the
employer to withhold or divert a portion of an employee's
wages must shall be in writing and must specify the reason
for the deduction.
(b) An authorization for withholding of wages must shall
be signed on or before the payday for the pay period from
which the deduction is to be made. The two permissible
types of authorization are the specific authorization and the
blanket authorization.
(c) A specific authorization may be for one or more
paychecks and muot shall state the dollar amount or percent-
age of wages which the employee agrees may be deducted
from each paycheck. Employees must shall be given a
reasonable opportunity to withdraw specific authorizations
if such deductions are for their convenience. Deductions for
the convenience of the employees may include, but are not
limited to, such things as insurance, savings plans, credit
union installments, savings bonds, union or club dues,
uniform rental, uniform cleaning, parking and charitable
contributions. All othor authorizntiona for withholding o f
specific amounts, onoo agreed upon by an employee, may
not be withdrawn. A payroll deduction that satisfies a
requirement of the employer is not a deduction for the
convenience of the employee within the meaning of G.S. 95-
25.8(2). and the employer is not required to give employees
a reasonable opportunity to withdraw their authorization
prior to making such a deduction.
(d) A blanket authorization may be signed by an em-
ployee which authorizes specific categories of deductions or
withholdings without specifying an actual dollar amount.
When the amount of any such deduction becomes known,
the employer m&f shall not make the deduction until the
employee has been given advance notice of the specific
amount of the proposed deduction and has been given a
reasonable opportunity to withdraw h+s authorization before
the deduction is made. What constitutes advance notice for
deductions involving cash shortages, inventory shortages, or
loss or damage to an employer's property is at least the
♦
143
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
seven day period prescribed in G.S. 95-25.9 and Rule .0304
of this Section.
(e) Specific and blanket authorizations signed by an
employee aaay shall not waive and must shall comply with
the authorization requirements, monetary limitations and
time requirements specified in G.S. 95-25.8, 95-25.9 and
95-25.10 of the Wage and Hour Act, and the rules and
regulations promulgated thereunder.
(f) G.S. 95-25.8(2) requires the employer under certain
circumstances to give the employee a reasonable o pportunity
to withdraw the employee's authorization. In determining
whether the employee was in fact given a "reasonable
o pportunity", such factors as the amount of time between
when the employee was given advance notice of the em-
plover's intent to deduct under the authorization, the time of
the deduction, and the accessibility to the employee of the
person designated to receive such withdrawals shall be
considered, but under no circumstances shall an employee
be found to have been given a reasonable o pportunity to
withdraw the authorization if the employee did not have
knowledge of the right to withdraw. While not required,
the inclusion of a notice of the right to withdraw in the
authorization signed by the employee shall be presumptive
evidence that the employee had knowledge of that right.
(g) The taking of a wage credit for an advancement of
wa ges does not fall within the scope of G.S. 95-25.8(2). and
no written authorization is required prior to crediting the
advancement toward wages due.
(h) An employee's authorization in accordance with G.S.
95-25.8(2) to allow an employer to withhold or divert a
portion of the employee's wages shall be invalid if the
reason for the deduction or withholding is illegal. For
example. G.S. 97-21 invalidates agreements by an employee
to pay any portion of a premium paid by his or her em-
ployer to a workers' compensation insurance carrier, and 13
NCAC 7F.0101(a) requires the employer to provide, at no
cost to the employee, all personal protective equipment
which the employee does not wear off the jobsite for use off
the job. If an employer withholds or diverts wages for
either of these reasons, even if the employee authorizes the
withholding in writing pursuant to G.S. 95-25.8(2). the
employer shall be in violation of G.S. 95-25.6 or G.S. 95-
25.7. or both, because that authorization is invalid.
ill If the employer obtains written authorization pursuant
to G.S. 95-25 .8(2)(a) to withhold a specific amount or
percentage from a series of paychecks to recover an amount
other than an advance owed to the employer and includes in
the authorization a provision for deducting the balance of the
unpaid amount from the employee's paycheck in the event
the employee separates before the full amount has been
collected, the employer may deduct as much of the balance
possible from the final paycheck without having to give the
employee notice of the amount and a reasonable opportunity
to withdraw his or her authorization as required by G.S. 95-
25.8(2)(b). subject to the withholding limitations of G.S. 95-
25.10. If the employer does not include in the specific
authorization an express provision to deduct the balance
upon an employee's separation, then an employer shall not
deduct from the final paycheck an unpaid balance which is
greater than the specific amount or percentage authorized
unless an additional authorization is obtained.
(i) Where tips or the reasonable costs of furnishing
employees with meals, lodging or other facilities are
credited as wages paid to an employee pursuant to the
provisions of Chapter 95. Article 2A and this Chapter, the
employer is not required to obtain prior written authoriza-
tion pursuant to G.S. 95-25.8(2) since a wage credit is not
a withholding of wages.
(k) An employer shall comply with G.S. 95-25.8(2)
before making a deduction from an escrow or bond account
funded by wages and established for the purpose of recover-
ing amounts owed to the employer.
Statutory Authority G.S. 95-25.8; 95-25.9; 95-25.10; 95-
25.11; 95-25.13, 95-25.19.
.0308 ,03018 VACATION PAY
(a) The purposes of the vacation provisions of the Wage
and Hour Act are to ensure that employees know what their
vacation benefits are and that they receive the promised
benefits. Employees mu n i shall be notified of company the
employer's policies and practices concerning vacation pay
in two ways. Pursuant to G.S. 95-25.13(1), an e mploy ee
employees must shall initially be notified orally or in writing
at the time of hiring. Pursuant to G.S. 95-25.13(2), an
employee employees must shall ake subsequently be notified
by making a copy of the policies and practices available to
them in writing or through a posted notice maintained in a
place accessible to the employee employees . All vacation
policies and practices communicated to employees must shall
address: the method of vacation calculation so that the
employees know e mploy ee knows the number of days of
vacation to which he is they are entitled; whether or not
vacation days may be carried forward from one year to
another; when vacation days must be taken; when and if
vacation pay may be paid in lieu of time off; and, under
what conditions and in what amount vacation pay will be
paid upon termination. Ambiguous policies and practices
will shall be construed against the employer and in favor of
the employees.
(b) If a company providoo vacations, all vacation time or
payment in liou of time off mu s t bo paid to the employee s
in aooordanoe with e stablish e d company policy or past
praotio e as known and und e rstood by the employees.
£b)(e) Any employer who fails to notify an employee in
accordance with G.S. 95-25.13 and Paragraph (a) of this
Rule, of any policy or practice which requires or results in
a loss or forfeiture of vacation time or pay, is liable for
such vacation time and pay without loss or forfeiture by the
employee.
Statutory Authority G.S. 95-25.12; 95-25.13; 95-25.19.
.0309 t0307 BONUSES AND COMMISSIONS
10:2
NORTH CAROLINA REGISTER
April 17, 1995
144
PROPOSED RULES
(a) Payment of wages based on bonuses, commissions or
other forms of calculation may be paid as infrequently as
annually, so long as employees are notified in advance of
earning such wages of the employer's time for payment of
such wages. Employees must shall also be notified in
accordance with the provisions of G.S. 95-25.13 of any
oompany policy or practice which requires or results in
forfeiture of such wages.
(b) Employees must shall be notified of the time for
payment and of forfeiture policies relating to wages based
on bonuses, commissions or other forms of calculation in
two ways. Pursuant to G.S. 95-25.13(1), an omployoo
employees must shall initially be notified orally or in writing
at the time of hiring. Pursuant to G.S. 95-25.13(2), a«
employe e employees must shall subsequently also be notified
by making a copy of the policies and practices available to
them in writing or through a posted notice maintained in a
place accessible to the employ ee employees .
(c) Any employer who fails to notify an employee in
accordance with G.S. 95-25.13, and Paragraphs (a) and (b)
of this Rule, is liable for such wages based on bonuses,
commission or other forms of calculation without forfeiture
by the employee.
Statutory Authority G.S. 95-25.6; 95-25.7; 95-25.13; 95-
25.19.
.0310 FINAL PAY
(a) For the purposes of determining pursuant to G.S. 95-
25.7 the payday on which separated employees shall be paid
all wages due, the "next regular payday* is that payday for
the pay period during which the employee separates from
employment or. in the case of commissions, bonuses and
other forms of calculation, the first regular payday is that
payday for the pay period during which such wages become
calculable.
(b) G.S. 95-25.7 requires the employer to mail the final
paycheck to the employee at its own expense if requested by
the employee. Employers shall not withhold the final
paycheck because the employee refuses to come to the
business office or place of employment to pick up the
paycheck if the employee requests the employer to mail it to
him/her in accordance with G.S. 95-25.7. The employer
may require the employee to provide a notarized or wit-
nessed written request to avoid fraudulent requests. In all
cases, the employee is owed the wages due until he/she
receives his/her final paycheck. However, if the check is
dishonored by the financial institution against which it is
drawn, then the employer's obligation to pay the wages
remains.
(c) If an employee requests to receive the final paycheck
by mail pursuant to G.S. 95-25.7. the employer shall not,
without written authorization pursuant to G.S. 95-25.8.
deduct any costs related to the replacement of a paycheck
which is lost or stolen prior to the employee's receipt of the
check.
Statutory Authority G.S. 95-25.7; 95-25.8; 95-25.19.
.0311 ADVANCEMENT OF WAGES
(a) The requirement of G.S. 95-25.6 that the employer
shall pay every employee all wages and tips accruing to the
employee on the regular payday is met if the employer pays
the accrued wages in advance of the regular payday.
(b) Any form of wages advanced by an employer to an
employee which have not been repaid by the employee may
be used by the employer as a credit toward any other form
of wages due the employee. For example, if an employer
has advanced an employee two weeks' wa ges and the
employee quits after working only one more week, the
employer may credit the second week's advanced wages
toward any vacation pay owed to the employee at separa-
tion.
(c) Amounts which an employer has advanced to an
employee through a payment to a third party primarily for
that employee's benefit and at the employee's request or
with the employee's knowledge and consent may be credited
toward wages owed to the employee without first obtaining
the prior written authorization required by G.S. 95-25.8(2).
For example, if an employer pays an employee's car loan
payment at the employee's request, the employer may credit
the amount paid on the employee's behalf as an advance
toward the employee's accrued wages. A dated receipt
evidencing the payment to the third party, signed by the
employee, shall be sufficient to show that the advancement
was requested or a pproved and made.
Statutory Authority G.S. 95-25.2(16); 95-25.8; 95-25.19.
.0312 LOANS FROM EMPLOYERS TO
EMPLOYEES
(a) In the absence of an executed loan document, the
principal of a loan from an employer to an employee is an
advance of wages. The loan shall be from the employer and
not a personal loan merely from a supervisor or another
employee. If the employer is a corporation, the loan shall
have been made from corporate funds. If the employer is
a sole proprietor or a partnership, a loan from the proprietor
or any partner shall constitute a loan from the employer and
may be treated as an advance of wages.
(b) A loan includes credit advanced by the employer to an
employee for purchasing from the employer items not
primarily for the benefit of the employer.
(c) A deduction for interest and other charges related to
the loan shall only be withheld from the employee's wages
with proper authorization under G.S. 95-24.8(2).
(d) A loan from a third party, such as a bank or credit
union, is not an advance of wages, and written authorization
under G.S. 95 -25. 8 (2) shall be secured by the employer
prior to deducting for such a loan.
Statutory Authority G.S. 95-25.2(16); 95-25.8; 95-25.13;
95-25. 19.
.0313 MISCALCULATION OF WAGES
(a) An overpayment to an employee as a result of a
miscalculation of wages or other bona fide error may be
145
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
treated as an advance-
da) When a miscalculation of wages or other bona fide
error results in a payment of wages less than the actual
wages accrued during the pay period, a violation of G.S.
95-25,6 shall have occurred, and the employer shall pay the
amount due as soon as possible upon the discovery of the
error together with interest at the legal rate set forth in G.S.
24-1 from the date the wages first became due.
Statutory Authority G.S. 95-25.2(16); 95-25.6; 95-25.19.
.0314 FORM OF PAYMENT OF WAGES
Since G.S. 95-25.6 and G.S. 95-25.7 do not provide for
a specific form of payment, the employer may select any
legal form of payment, so long as payment is made in full
on the designated payday, subject to authorized deductions
and legal withholdings. Acceptable forms of payment
include cash, money order, negotiable checks, and direct
deposit into an institution whose deposits are insured by the
United States government or an institution selected by the
employee.
Statutory Authority G.S. 95-25.6; 95-25.7; 95-25.19; 95-
245.
.0315 OTHER AMOUNTS PROMISED AS WAGES
So long as the employer has promised to make such
payments and has a policy or practice of making such
payments, wages in the form of "other amounts promised"
as that term is used in G.S. 95-25.2(16) include, but are not
limited to such other forms of compensation as travel
expenses, holiday pay, birthday pay, jury duty pay, shift
premium pay, prizes such as trips if commission quota is
met, moving expenses, educational expenses, telephone
expenses, and other reimbursements so long as the employer
has promised to make such payments and has a policy or
practice of making such payments.
Statutory Authority G.S. 95-25.2(16); 95-25.19.
SECTION .0500 - JURISDICTION
AND EXEMPTIONS
.0501 EXEMPTIONS
(a) The exemption from minimum wage, overtime, youth
e mployment and recordkeeping, for any person covered by
th e Fair Labor Standnrdo Aot, appli e o to p e roono whos e
wages, ov e rtime, and conditions and reoordo of e mploym e nt
are regulated by the Fair Labor Standards Act and the rule s
promulgated thereunder. Persons covered by the Fair Labor
Standards Aot, but whoo e wages, ov e rtim e , and conditions
and rooords of e mploym e nt ar e e x e mpted from f e d e ral
regulation, are subject to the state wage and hour provisions
unless sp e cifically exempted by the Wage and Hour Act.
(a) Subject to the specific exceptions stated in sub-
subdivisions a^ b^ and c of G.S. 95-25. 14(a)(1). that sub-
division exempts from minimum wage, overtime, and youth
employment coverage of the Wage and Hour Act certain,
but not all employees covered by the minimum wage,
overtime, and youth employment provisions of the Fair
Labor Standards Act. 29 USC §201 et seq (herein "FLSA").
Only those employees employed by an "enterprise engaged
in commerce or the production of goods for commerce" as
defined in 29 USC §203(s) are exempt from those provi-
sions of the Wage and Hour Act. Employees who are
covered by the FLSA by virtue of their involvement in
interstate commerce, but who are not employed by an
enterprise engaged in interstate commerce, are not exempt
from the Wage and Hour Act provisions under this sub-
division and are covered by both Acts.
(b) For the purpose of clarifying the exemptions under
G.S. 95-25. 14(a)(1)(c) of the Wage and Hour Act, where
the FLSA provides an exemption from minimum wage,
overtime or child labor to an employee in a FLSA covered
enterprise and the Wage and Hour Act does not contain the
same exemption, the employees and employers so exempted
by the FLSA shall be covered under the North Carolina
Act. The following are some examples of FLSA covered
enterprises whose employees, exempted from FLSA provi-
sions, continue to have full minimum wage and overtime
coverage under G.S. 95-25.3 and G.S. 95-25.4 of the Wage
and Hour Act due to the FLSA exemption noted:
(1) Seasonal amusement or recreational establish-
ments as exempted under 29 USC 8213(a)(3).
(2) Small newspapers as exempted under 29 USC
§2 13(a)(8).
(3) Small public telephone companies as exempted
under 29 USC §213(a)(10).
(c) Where the FLSA provides exemptions from its
overtime requirements to certain FLSA covered employees
or employers and the Wage and Hour Act does not contain
the same exemption, such FLSA exempted employees and
employers shall be covered under the North Carolina Act.
The following are some examples of such employees and
employers:
(1) Outside buyers of poultry, eggs, and milk as
exempted under 29 USC §213(b)(5).
(2) Small grain elevators as exempted under 29 USC
§213(b)(14).
(3) Maple sugar or syrup processors as exempted
under 29 USC §213(b)(15).
(4) Employees engaged in intra-state transportation
of fruits or vegetables as exempted under 29
USC §213(b)(16).
(5) Motion picture theaters as exempted under 29
USC §213(b)(27).
(6) Small lumbering or forestry operations as ex-
empted under 29 USC §213(b)(28).
(7) Newspaper carriers and makers of wreaths
composed of natural materials as exempted
under 29 USC §213(d).
(d) Where the FLSA contains an overtime exemption
which provides a method for calculating overtime in the
alternative to the normal time and one-half the regular rate
10:2
NORTH CAROLINA REGISTER
April 17, 1995
146
PROPOSED RULES
of pay for hours worked in excess of 40 in a workweek, and
the North Carolina Wage and Hour Act does not contain
such exemptions, the Wage and Hour Act adopts by refer-
ence the FLSA exemption with the alternate overtime
calculation methods and applies those methods to similar
state-covered businesses. The following are examples of
FLSA overtime exemptions which provide for an alternate
method for calculating overtime and which are adopted by
reference under G.S. 95-24. 14(a)(1)(c):
£1) 29 USC 5207(b)(3) which exempts employees of
certain petroleum distributors.
(2) 29 USC 8207(f) which exempts certain employ-
ees who work irregular hours and are paid a
guaranteed salary.
(3) 29 USC 5207(g) which exempts certain piece
rate workers.
(4) 29 USC §207(0 which exempts certain commis-
sioned inside salespersons in retail.
(5) 29 USC §207(j) which exempts certain employ-
ees of hospitals, nursing homes, old age homes.
(6) 29 USC §207(m) which exempts certain seasonal
employees at tobacco warehouses and auctions.
£7) 29 USC 8207(n) which exempts certain bus
drivers.
£8) 29 USC §213(b)29 which exempts certain em-
ployees of concessionaires in national parks.
£9} 29 USC §2 13(h) which exempts certain seasonal
employees in cotton pinning, sugarcane or
sugarbeet processing.
(10) 29 USC §213(i) which exempts certain seasonal
employees in local cotton ginning.
(11) 29 USC §213(j) of the FLSA which exempts
certain seasonal employees in sugar processing.
(e)fb> The statutory exemption from certain wage and
hour provisions for the spouse, child, parent or dependent
of the employer applies equally to the spouse, child, parent
or dependent of corporate officers. For the purposes of this
Section only, corporate officers are those who dir e ctly h e ad
control the day to day affairs of the establishment and:
(1) are majority stockholders, or
(2) are principal stockholders with voting control, or
(3) are in voting control through stock ownership or
with joint ownership of spouse or family.
£f}(e) Homes for dependent children pursuant to G.S.
95-25. 14(c)(6) include institutions and group homes for
dependent children.
Statutory Authority G.S. 95-25.14; 95-25.19.
.0502 COUNTING EMPLOYEES
(ft) — For th e purpos e of e stablishing jurisdiction pursuant
to G.S. 95 25.1 4 (bX5), a proprietor or ownor who works in
and about hi s enterpri s e is not counted as a person employed
in th e e nt e rpris e .
(b) With r e opeot to a businooo sot up as a oorporation, if
an office r of the corporation only performs dut i es of an
executive nature, ho will not be oounted as an employee.
How e ver, — if an offioor porforms manag e rial — or oth e r
non executive duties, he is an employee of the oorporation
and will b e oount e d for jurisdictional purpos e s.
fe-) — With r e opoot to partnership s , a partn e r who has a
substantial ownership interest and functions as a proprietor
or ownor will bo treated as an employer. Whore the partner
ship inter e st and inoid e no e of ownership authority ar e d e
minimis, a partn e r will b e oounted as an e mploye e^
(d) Part time employees and family members who work
in an enterprise will be oounted in determining the numbe r
of persons employed for jurisd i ctional purposes.
( e ) Th e numb e r of e mployoos at an e nterpris e who work
during the oourso of a workwook, not the number of
employees working on any particular day, determines the
wag e and hour jurisdiction for any workw ee k.
Statutory Authority G.S. 95-25.14; 95-25.19.
SECTION .0800 - RECORDKEEPING
.0803 SCOPE OF PROMISED WAGES
For the purposes of G.S. 95-25.13, the term "promised
wages" includes all forms of wages as defused in G.S. 95-
25.2(16). and any policy or practice with re gard to such
wages.
Statutory Authority G.S. 95-25.2(16); 95-25.19; 95-245.
.0804 NOTDJICATION AT TIME OF HDUNG
(a) The purpose of the notice provision of G.S. 95-
25. 13(1) is to ensure that employees know at the time of
hiring what wages they are promised, as well as any policies
or practices of the employer that may affect the rate or
amount of wages. The employee shall not be subject to any
policy or practice that decreases the employee's wages if the
employer does not provide the employee with express notice
orally or in writing of such policy or practice.
(b) A dated copy of an employer's written notification of
the promised wages bearing an employee's signature shall
be presumptive evidence of the employer's notification to
that employee of the information contained in the notice on
the date stated.
(c) If an employer fails to inform an employee at the time
of hiring of any policy or practice regarding promised
wages which creates additional earning prerequisites or
which could result in a decrease in the employee's wages,
the policy or practice shall not be effective as to that
employee until the employee is notified of the policy or
practice pursuant to G.S. 95-25.13(1).
Statutory Authority G.S. 95-25.13(1); 95-25.19.
.0805 NOTDJICATION DURING TENURE OF
EMPLOYMENT
(a) The purpose of G.S. 95-25.13(2) is to ensure that
employees have ready access to a written statement of the
employer's policies and practices regarding promised wages
throughout their tenure with the employer so that they are
capable of making use of the information contained therein.
147
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
If the employer chooses to comply with this notice require-
ment by posting a copy of its practices and policies relating
to the promised wages, they must be posted in such a
manner and in such a place and during such times as to
meet the purpose of this Section. If not so posted, the
employer shall ensure that a written copy of such policies
and practices is freely obtainable or easily accessible in a
timely manner for review by the affected employees.
(b) While not the only acceptable method for compliance,
an employer who gives to all its employees an "employee
handbook" or other written statement setting forth the
policies and practices with regard to promised wages shall
be presumed to have met the requirement of G.S. 95-
25.13(2).
(c) Payroll records, including check stubs, if made
available to employees, may be used to satisfy the require-
ment of G.S. 95-25.13(2) for wages promised in the form
of hourly pay, salary or other form whose terms are readily
identifiable from the payroll records.
(d) The employer's failure to comply with the require-
ment to have a policy or practice in writing under G.S. 95-
25.13(2) shall not affect the employer's obligation to pay
employees all wages promised in accordance with the
employer's unwritten policy or practice with regard to such
wages.
(e) A policy or practice resulting in the loss or forfeiture
of vacation time or pay, commissions, bonuses, or other
forms of calculation is not subject to Paragraph (d) of this
Rule and such policies or practices shall be unenforceable if
they are not in writing as required under G.S. 95-25.13(2).
Statutory Authority G.S. 95-25.13(2); 95-25.19; 95-245.
.0806 NOTIFICATION OF CHANGES
IN PROMISED WAGES
(a) The purpose of G.S. 95-25.13(3) is to ensure that
employees know of any changes La promised wages prior to
the time of such changes, particularly changes that decrease
their wages. The employer is required to take appropriate
actions reasonably calculated to inform the affected employ-
ees, in writing or through a posted notice, of such changes.
The notice shall be such that a reasonable employee acting
with ordinary diligence would be informed of the change in
promised wages.
(b) A change in an employer's policy or practice may
occur in two ways:
(1) in writing; or
(2) through a succession of consistent actions taken
by the employer which deviate from a prior
written or unwritten policy or practice.
(c) The determination whether the set of actions with
regard to promised wages constitute a "change" in the
employer's practice or policy shall be made depending on
such factors as the number, consistency, timing and reason
for the deviating actions.
(d) No change in a policy and practice with regard to
promised wages, whether in writing or not, shall be effec-
tive until written notice is given to the employees as
required in G.S. 95-25.13(3). except to the extent that such
changes have the effect of increasing wages.
Statutory Authority G.S. 95-25.13(3); 95-25.19; 95-245.
.0807 MEANING OF "MAINTAINED IN A PLACE
ACCESSIBLE"
For the purposes of G.S. 95-25.13(2) and (3). the phrase
"maintained in a place accessible" a pplies to the posting and
to the writing. "Accessible" with respect to posting means
"easily a pproached and viewed for reading", at a place
designated for such purposes and regularly frequented by the
affected employees. "Accessible" with respect to the
writing means "easily and promptly obtained or viewed for
reading" at a place designated for maintaining such writings.
Statutory Authority G.S. 95-25.19; 95-245.
.0808 METHODS OF PROVIDING EMPLOYEES
WITH ITEMIZED STATEMENT OF
DEDUCTIONS
G.S. 95-25.13(4) requires the employer, in all circum-
stances, to furnish the employee with an itemized statement
of deductions made from that employee's wages under G.S.
95-25.8. Generally, the employer shall provide such a
statement in writing. However, it is also sufficient for the
employer to furnish the employee with the itemized state-
ment of deductions via telecommunications . for example,
electronic mail, but only if such a transmission is capable of
being printed out as a paper copy by the employee.
Statutory Authority G.S. 95-25.19; 95-245.
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Department of
Labor intends to adopt rules pertaining to the Wage and
Hour Act. The agency will subsequently publish in the
Register the text of the rule(s) it proposes to adopt as a
result of the public hearing and of any comments received on
the subject matter.
Statutory Authority: G.S. 95-25.1 et seq.
Proposed Effective Date: October 1, 1995.
A Public Hearing will be conducted at 10:00 a.m. on
Friday June 2, 1995 at the Agriculture Building, 2 West
Edenton Street, Room 359, Raleigh, NC.
Reason for Proposed Action: To provide necessary rules
for the Wage and Hour Act, particularly with regard to
recordkeeping and youth employment issues.
Comment Procedures: Please submit your comments to
10:2
NORTH CAROLINA REGISTER
April 17, 1995
148
PROPOSED RULES
Mr. Scott Templeton, APA Coordinator, N C. Department of
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX (919)
715-5629; Telephone (919) 733-0368 by June 2, 1995. You
may present written or oral comments at the hearing;
however, time limits may be imposed by the Chair.
Notice is hereby given in accordance with G.S.
15 OB -2 1.2 that the North Carolina Department of
Labor intends to adopt rules regarding the Migrant Housing
Act of North Carolina. The agency will subsequently publish
in the Register the text of the rule(s) it proposes to adopt as
a result of the public hearing and of any comments received
on the subject matter.
Statutory Authority: G.S. 95-222 et seq.
Proposed Effective Date: January 1, 1996.
A Public Hearing will be conducted at 9:00 a.m. on August
18, 1995 at the NC Department of Agriculture Building, 2
W. Edenton Street, Room 359, Raleigh, NC 27601.
Reason for Proposed Action: To update the administrative
rules regarding the Migrant Housing Act.
Comment Procedures: Please submit your comments to
Mr. Scott Templeton, APA Coordinator, NC Department of
Labor, 4 West Edenton Street, Raleigh, NC 27601, FAX
(919) 715-5629; Telephone (919) 733-0368 by August 18,
1995. You may present written or oral comments at the
hearing; however, time limits may be imposed by the Chair.
Labor, 4 West Edenton Street, Raleigh, NC 27601, FAX
(919) 715-5629; Telephone (919) 733-0368 by May 18,
1995. You may present written or oral comments at the
hearing; however, time limits may be imposed by the Chair.
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Department of
Labor intends to adopt rules pertaining to the Retaliatory
Employment Discrimination Act. The agency will subse-
quently publish in the Register the text of the rule(s) it
proposes to adopt as a result of the public hearing and of
any comments received on the subject matter.
Statutory Authority: G.S. 95-240 et seq.
Proposed Effective Date: February 1, 1996.
A Public Hearing will be conducted at 2:00 p.m. on
Thursday, May 18, 1995 at the Agriculture Building, 2 West
Edenton Street, Room 359, Raleigh, NC 2/601.
Reason for Proposed Action: To provide rules for the
Retaliatory Employment Discrimination Act.
Comment Procedures: Please submit your comments to
Mr. Scott Templeton, APA Coordinator, NC Department of
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX (919)
715-5629; Telephone (919) 733-0368 by May 18, 1995. You
may present written or oral comments at the hearing;
however, time limits may be imposed by the Chair.
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Department of
Labor intends to adopt rules regarding regulation of job
listing services. The agency will subsequently publish in the
Register the text of the rule(s) it proposes to adopt as a
result of the public hearing and of any comments received on
the subject matter.
Statutory Authority: G.S. 95-47.19 et seq.
Proposed Effective Date: January 1, 1996.
A Public Hearing will be conducted at 9:00 a.m. on May
18, 1995 at the NC Department of Agriculture Building, 2
W. Edenton Street, Room 359, Raleigh, NC 27601.
Reason for Proposed Action: To provide administrative
rules for the Regulation of Job Listing Services Act.
Comment Procedures: Please submit your comments to
Mr. Scott Templeton, APA Coordinator, NC Department of
TITLE 15A - DEPARTMENT OF
ENVIRONMENT, HEALTH, AND
NATURAL RESOURCES
Notice is hereby given in accordance with G.S.
150B-21.2 that the EHNR - Sedimentation Control
Commission intends to adopt rule cited as 15 A NCAC 4B
.0028.
Proposed Effective Date: July 1, 1995.
A Public Hearing will be conducted at 9:00 a.m. on May
8, 1995 at the Ground Floor Hearing Room, Archdale
Building, 512 N. Salisbury Street, Raleigh, NC.
Reason for Proposed Action: This new rule is needed to
clarify the authority of the Sedimentation Control Commis-
sion to regulate land-disturbing activities under-taken by
railroad companies. Specifically , the Commission must
recognize a zone of federal preemption within railroad
rights-of-way which is established by federal law. Outside
♦
149
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
this zone, the Office of the Attorney General has advised that
the Commission does have authority to enforce the Sedimen-
tation Pollution Control Act of 1973.
Comment Procedures: Any person requiring information
may contact Mr. Craig Deal, Land Quality Section, PO Box
27687, Raleigh, NC 27611 - Telephone - (919) 733-4574.
Written comments may be submitted to the above address no
later than May 17, 1995.
Fiscal Note: This Rule does not affect the expenditures or
revenues of local government or state funds.
CHAPTER 4 - SEDIMENTATION CONTROL
SUBCHAPTER 4B - EROSION AND SEDIMENT
CONTROL
TITLE 21 - OCCUPATIONAL
LICENSING BOARDS
CHAPTER 1 - NORTH CAROLINA
ACUPUNCTURE LICENSING BOARD
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Acupuncture
Licensing Board intends to amend rule cited as 21 NCAC 1
.0101; adopt rules .0401 and .0402.
Proposed Effective Date: July 1, 1995.
A Public Hearing will be conducted at 3:00 p.m. on May
2, 1995 at the Pack Memorial Library, 67 Haywood St. ,
Asheville, NC.
.0028 RAILROAD COMPANIES
(a) The Commission recognizes that under the Federal
Railroad Safety Act of 1970 (FRSA). 45 U.S.C. 421 et
seq.. as interpreted by federal administrative rules and court
decisions, existing railroad roadbeds comprise a zone of
federal preeminence within which federal law takes prece-
dence over the Act rthe SPCA1.
£b) While the specific definition of this zone of federal
preeminence is a question of federal law and regulation, in
general the zone of federal preeminence extends outward
from the center of the railroad roadbed to and including
drainage ditches and spoil banks on either side of the
roadbed.
(c) In the event of a derailment, washout, or other
emergency condition which requires immediate action to
protect public safety, the zone of federal preeminence
temporarily expands, for the duration of the emergency
condition, to encompass areas adjacent to die roadbed within
which emergency repairs are undertaken pursuant to the
FRSA and Federal Railroad Administration rules.
(d) The Act and rules do not apply to activities conducted
within the zone of federal preeminence. The Act and rules
apply to all other activities conducted by railroad companies.
(e) A railroad company's failure to comply with a
requirement of the Act or rules in order to avoid creating a
safety hazard or to avoid noncompliance with a federal
safety requirement is not a knowing or willful violation of
the Act or rules.
(f) The Commission will provide advice and technical
assistance to railroad companies in the development and
implementation of voluntary best management practices to
reduce environmental impacts that may otherwise result
from activities conducted within the zone of federal preemi-
nence.
Statutory Authority G.S. 113A-52(6); 113A-54(b); 113A-
54(c); U3A-54(d)(4); 113A-57(1).
Reason for Proposed Action:
21 NCAC 1 .0101 - This rule was adopted effective August
1, 1994. A typographical error was made and the word
"not " was left out.
21 NCAC 1 .0401 & .0402 - To adopt rules to establish
practice parameters and procedures for the practice of
acupuncture in North Carolina.
Comment Procedures: Any person may submit written
comments to the Board until May 17, 1995 or speak to the
Rule- making Coordinator at the Public Hearing on May 2,
1995 at 3:00 p.m. at Pack Memorial Library in Asheville,
NC.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
SECTION .0100 - LICENSURE
.0101 QUALIFICATIONS FOR LICENSURE
In addition to and for the purposes of meeting the require-
ments of G.S. 90-455 an applicant for licensure to practice
acupuncture shall:
(1) Submit a completed application,
(2) Submit fees as required by Rule .0103 of this
Section,
(3) Submit proof of a score of not less than 70% on
the National Commission for the Certification of
Acupuncturists (NCCA) certifying examination or
a score of not less than 70% from any state
utilizing the NCCA examination,
(4) Submit a certified copy, certified by the issuing
institution, of a transcript including evidence of
graduation from a three-year postgraduate acu-
puncture college,
(5) Submit proof of successful completion of the
Clean Needle Technique course offered by the
Council of Colleges of Acupuncture and Oriental
Medicine (CCAOM),
10:2
NORTH CAROLINA REGISTER
April 17, 1995
150
PROPOSED RULES
(6) With any document that is not in English in its
original form, submit a translation of it into
English by someone other than the applicant.
Each translated document shall have affixed to it
a notarized statement of the translator certifying
that he or she is competent in both the language of
the original document and English and that the
translation is a true and complete translation of the
foreign language original. The applicant shall
assume the cost of any document necessary for a
complete application,
(7) Submit all correspondence to North Carolina
Acupuncture Licensing Board, P.O. Box 25171,
Asheville, NC 28803.
Statutory Authority G.S. 90-454; 90-455.
SECTION .0400 - PRACTICE PARAMETERS
AND PROCEDURES
.0401 PRACTICE PARAMETERS
The following are the practice parameters for acupunctur-
ists in North Carolina:
(1) A licensed acupuncturist shall practice within the
scope of training offered by a college certified by
the National Accreditation Commission for
Schools and Colleges of Acupuncture and Oriental
Medicine.
£2} A licensed acupuncturist must practice within the
confines of his training. Parameters for diagnosis
and treatment of patients include. Five Elements.
Eight Principles, Yin Yang Theory, Channel
Theory. Organ Theory. Six Stage and 4 Aspects
of Disease Progressions.
Statutory Authority G. S. 90-454.
.0402 ACUPUNCTURE PROCEDURES
The following procedures shall be followed within the
practice of acupuncture:
(1) Practice Setting:
(a) Treatments shall be given in surroundings that
provide privacy and confidentiality.
£b) Every acupuncture office shall be maintained in
a clean and sanitary condition at all times, and
shall have a readily accessible bathroom facility.
(c) OSHA Standards for Blood Borne Pathogens
shall be met.
New Patient Intake:
01
£al
Ibj
Prior to treatment, a written or oral medical
history shall be obtained from the patient. Oral
statements shall be reflected in the practitioner's
notes. Information shall include current and past
medical illnesses, treatments, hospitalizations,
current medications and allergies to medications.
A social history shall include use of tobacco,
alcohol, caffeine and recreational drugs.
The names of current health practitioners shall
121
(11
£51
£§1
(J2l
(61
(21
m
til
(el
be listed.
The current complaints shall be outlined along
with remedies and treatments tried and in prog-
ress.
The possibility of pregnancy or the presence of
biomedical devices, such as artificial joints or
cardiac pacemaker shall be ascertained.
Fees. Information concerning fees shall be made
available prior to treatment.
Guarantees. No guarantee or implied guarantee
about the success of treatment shall be given.
Reasonable indication of the length of treatment
and usual outcome shall be given.
Diagnosis:
Diagnosis shall be made utilizing methods
connected with the traditions represented in
Chinese medicine as listed in Rule .0104 of this
Chapter. Examples of diagnostic measures
include the Eight Principles. Five Elements.
Pulse diagnosis, and Tongue diagnosis.
The diagnostic procedures shall be recorded at
each visit-
Treatment. The specifies of the treatment shall be
recorded at each visit-
Medical Records. Dated notes of each patient
visit and communication shall be kept. These
records may only be made available to other
parties with the patients's written authorization.
Failure to Progress:
If a patient fails to respond to treatments as
expected, discussion about other forms of treat-
ment or referral to another health care profes-
sional shall be made.
In the case of persistent, unexplained pain, or
the unexplained worsening of any condition in
the face of ongoing treatment, referral or consul-
tation shall be made. In choosing a referral
source, priority shall be given to previously seen
practitioners if possible-
Requests by the patient for information about
other forms of treatment or referral shall always
be honored.
Statutory Authority G. S. 90-454.
CHAPTER 32 - BOARD OF MEDICAL
EXAMINERS
Notice is hereby given in accordance with G.S.
150B-21.2 that the Board of Medical Examiners of the
State of North Carolina intends to amend rules cited as 21
NCAC 32H .0102, .0201, .0601 - .0602, .0801, .1001; 321
.0003 - .0004 and adopt 32H .0203, .0408, and .0506.
151
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
Proposed Effective Date: 21 NCAC 32H .0102, .0201,
.0203, .0408, .0506, .0602, .0801, .1001 -July 1, 1996.
21 NCAC 32H . 0601; 321 . 0003 - . 0004 - July 1 , 1995. (4)
A Public Hearing will be conducted at 1:00 p.m. on May
3, 1995 at the North Carolina Division of Facility Services,
701 Barbour Drive, Room 201, Raleigh, NC 27603.
Reason for Proposed Action:
21 NCAC32H .0102, .0201, .0203, .0408, .0506, .0602, (5)
.0801, .1001 - To establish rules for a new class of ALS
Professionals who will work as dispatchers.
21 NCAC 32H .0601 - To deliniate grounds for disciplinary
actions against ALS Professionals.
21 NCAC 321 .0003 - .0004 - To extend the approval period
for use of Epinephrine for adverse reaction to bee stings
from 1 year to 4 years. (6)
Comment Procedures: Persons interested may present
written or oral statements relevant to the proposed actions
at a hearing to be held as indicated above. Written state-
ments not presented at the hearing should be directed to:
Administrative Procedures, NC Board of Medical Examiners,
PO Box 20007, Raleigh, NC 27619, no later than May 17, (7)
1995.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
SUBCHAPTER 32H - EMERGENCY MEDICAL
SERVICES ADVANCED LIFE SUPPORT
SECTION .0100 - GENERAL INFORMATION
.0102 DEFINITIONS
The following definitions apply in this Subchapter:
(1) "Audit and review panel" means a committee
composed of representatives of the medical,
nursing, administrative and prehospital care
service elements of an advanced life support
(ALS) program that has the responsibility for the
on-going monitoring and evaluation of the pro-
gram. The chairman of the panel shall be a
physician and a majority of the voting members (10)
shall be physicians.
(2) "Emergency medical technician-advanced interme-
diate (EMT-AI)" means a person specially edu-
cated in a program approved by the Office of
Emergency Medical Services who has been certi-
fied or recertified by the Board of Medical Exam-
iners as qualified to render the services enumer-
ated in Rule .0406 of this Subchapter.
(3) "Emergency medical technician-defibrillation
(EMT-D)" means a person specially educated in a (11)
program approved by the Office of Emergency
Medical Services who has been certified or recer-
tified by the Board of Medical Examiners as
(8)
(9)
qualified to render the services enumerated in Rule
.0407 of this Subchapter.
"Emergency medical technician-intermediate
(EMT-I)" means a person specially educated in a
program approved by the Office of Emergency
Medical Services who has been certified or recer-
tified by the Board of Medical Examiners as
qualified to render the services enumerated in Rule
.0403 of this Subchapter.
"Emergency medical technician-paramedic (EMT-
P)" means a person specially educated in a pro-
gram approved by the Office of Emergency
Medical Services who has been certified or recer-
tified by the Board of Medical Examiners as
qualified to render the services enumerated in Rule
.0402 of this Subchapter.
"Advanced Life Support Professional (ALS Pro-
fessional)" means a certified emergency medical
dispatcher, emergency medical technician-defibril-
lation, emergency medical technician-intermediate,
emergency medical technician-advanced intermedi-
ate, or emergency medical technician-paramedic
whether working on a paid or volunteer basis.
"Medical control" means the management and
accountability for the medical care aspects of an
ALS program. It entails physician direction and
oversight of the initial education and continuing
education of the ALS professionals; development
and monitoring of both operational and treatment
protocols; evaluation of the medical care rendered
by ALS personnel; participation in system evalua-
tion; and directing, by radio or telephone, the
medical care rendered by the ALS professionals.
"Medical director" means the physician responsi-
ble for the medical aspects of the management of
an ALS program.
"Mobile intensive care nurse (MICN)" means a
registered nurse who has been approved or
reapproved by the Board of Medical Examiners to
issue instructions to ALS professionals in accor-
dance with protocols approved by the sponsor
hospital and under the direction of the medical
director.
"Advanced life support program (ALS program)"
means a program of prehospital emergency medi-
cal care whereby definitive medical care is deliv-
ered to a victim of sudden injury or illness by
appropriately educated and certified ALS profes-
sionals operating under the direction of a sponsor
hospital. All ALS programs shall conform to the
criteria established in the rules contained in this
Subchapter and must be approved by the Office of
Emergency Medical Services.
"Mobile intensive care unit" means any emergency
vehicle staffed by ALS professionals and equipped
in accordance with standards established by the
North Carolina Medical Care Commission as
10:2
NORTH CAROLINA REGISTER
April 17, 1995
152
PROPOSED RULES
found in 10 NCAC 3M .0202, .0203, .0204,
.0205, and .0207 to provide remote intensive care
to sick and injured persons at the scene of a
medical emergency and during transport to a
health care facility.
(12) "Oral interview panel" means a committee com-
posed of physicians, ALS professionals certified at
or above the level of application and may include
other medical personnel such as registered nurses
and mobile intensive care nurses involved in the
ALS program. The responsibility of the oral
interview panel is to interview each applicant for
certification, either collectively or individually,
and evaluate his suitability to perform successfully
at the certification level sought. The panel must
be approved by the medical director and consist of
a minimum of three members including one
physician and one ALS professional.
(13) "Office of Emergency Medical Services" means an
official agency of the State of North Carolina,
Department of Human Resources, that serves in
an administrative capacity to the Board of Medical
Examiners.
(14) "Physician" means an individual licensed by the
Board of Medical Examiners to practice medicine
in the State of North Carolina.
(15) "Sponsor hospital" means a hospital and its medi-
cal staff which participates in an ALS program
and has responsibility for providing or ensuring
the provision of initial education, continuing
education, education and medical control to the
ALS professionals. The sponsor hospital shall
meet criteria adopted by the Board of Medical
Examiners and be approved by the Office of
Emergency Medical Services.
(16) "Study project" means a proposal involving excep-
tions to the provisions of this Subchapter for the
purpose of evaluating the efficiency and effective-
ness of alternate means of providing ALS services
to the citizens of North Carolina.
(17) "Blind insertion airway device" means an airway
adjunct designed to be used as a pharyngeal or
esophageal device which is inserted without the
use of direct visualization. For the purposes of
these Rules, this definition does not include
esophageal obturator airways, esophageal gastric
tube airways, or endotracheal tubes.
(18) "Coding" means the selection and assignment of
an alphanumeric classification to a call for medical
assistance by an EMD.
(19) "Emergency Medical Dispatcher (EMD)" means
a trained public safety telecommunicator with
additional training and specific emergency medical
knowledge essential for the efficient management
of emergency medical service communications
who has successfully completed an education and
training program meeting the criteria established
by the Office of Emergency Medical Services and
who functions as an a gent or constituent of an
Emergency Medical Dispatch Program approved
by the Office of Emergency Medical Services.
(20) "Emergency Medical Dispatching " means the
reception and management of requests for emer-
gency medical assistance.
(21) "Emergency Medical Dispatch Program" means
the a pproved program with procedures established
for the management and delivery of emergency
medical assistance by a public or private agency
that sends emergency medical assistance to re-
questing persons and provides pre-arrival instruc-
tions for a victim of sudden injury or illness.
(22) "Emergency Medical Dispatch Priority Reference
System (EMDPRS)" means a medically approved
written or computer generated reference system
used by an emergency medical dispatching agency
to provide medical direction, and to dispatch aid
to medical emergencies.
(23) "EMD selection" means the process which estab-
lishes criteria to identify a candidate for education
and training as an Emergency Metiical Dispatcher
(EMD).
(24) "Pre-arrival instructions" means telephone ren-
dered, medically approved written instructions
read by emergency medical dispatchers to callers,
which help provide aid to the victim and control
the situation prior to patient access by pre-hospital
care providers.
(25) "Public Safety Telecommunicator* means an
individual trained to communicate by electronic
means with persons seeking emergency assistance
and with public or private agencies and individuals
providing such assistance.
(26) "A pproved Teaching Institution" means an agency
with a current contract with the Office of Emer-
gency Medical Services to provide emergency
medical services training programs.
Statutory Authority G.S. 143-514.
SECTION .0200 - PROGRAM STANDARDS
AND APPROVAL
.0201 ADVANCED LIFE SUPPORT PROGRAM
CRTTERIA
ALS programs shall cover a defined service area of
generally not less than one county and must have the
following:
(1) a plan, as specified in Rule .0302 of this Subchap-
ter, for the coordination of the sponsor hospitals
participating in the program;
(2) a designated medical director who shall be respon-
sible either directly or by clearly established
delegation to the other licensed physicians at the
sponsor hospital(s) for the following:
(a) the initial establishment,, a pproval and periodic
updating of treatment protocols or EMDPRS for
♦
153
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
I
%
emergency medical dispatch pro grams ;
(b) medical supervision of the selection, initial
education, continuing education and performance
of the ALS professionals and MICN personnel;
(c) the medical review of the care provided to
patients;
(d) keeping the care provided current with advanced
biomedical science and technology; and
(e) participation in the overall management of the
ALS program in liaison with nursing, technical,
and administrative staff of the program. The
medical director has the authority to suspend
temporarily, pending due process review, an
ALS professional or MICN from further partici-
pation in the ALS program when it is deter-
mined the activities or medical care rendered by
such personnel may be detrimental to the care of
the patient;
an organized and defined system of communica-
tions that provides for:
public access through a central emergency
communications center;
dispatch and coordination of all resources (man-
power, vehicles and equipment) essential to the
effective and efficient management of requests
for emergency medical assistance;
communications linkages for interacting with
other public safety agencies to obtain additional
resources required to support emergency medical
services activities; and
two-way voice communications as specified in
Rule .0303(a)(2)(H) of this Subchapter between
the ALS professionals and the personnel at the
sponsor hospital responsible for directing the
medical treatment rendered by the ALS profes-
sionals;
(4) adequate certified manpower to ensure that the
program will be continuously available on a 24
hour-a-day basis; and
(5) an audit and review panel that meets at a mini-
mum on a quarterly basis and whose responsibili-
ties include at least the following:
(a) reviewing ALS cases to determine the appropri-
ateness of the medical care rendered by all
personnel involved in the cases;
(b) making recommendations to the medical director
for the continuing education program for ALS
personnel; and
(c) reviewing the policies, procedures and protocols
of the ALS program and making recommenda-
tions for improvement.
Statutory Authority G.S. 143-514.
.0203 APPROVAL REQUIREMENTS: EMERGENCY
MEDICAL DISPATCHER PROGRAM
(a) All emergency medical dispatching agencies applying
(3)
(a)
(b)
(c)
(d)
the principles of EMD or offering EMD services, proce-
dures, or programs to the public shall conform to the
criteria established in the rules contained in this Subchapter
and shall submit a proposal for program a pproval to the
Office of Emergency Medical Services at least 60 days prior
to program implementation. The proposal must document
that the EMD program has:
LU
01
til
£51
m
m
IM
121
a defined service area:
a designated medical director responsible for
medical supervision of the program in accor-
dance with Rule .020U2)(a.)-(e) of this Section:
adopted, maintains, and updates on a regular
basis, a written or computer-based emergency
medical dispatch priority reference system
(EMDPRS) a pproved by the EMD program
medical director including at least the minimum
incident protocols set forth in the "Guidelines
for the Development and Operation of Emer-
gency Medical Dis patch Programs" dated March
1995. incorporated herein by reference:
adequate personnel certified in accordance with
the requirements of this Subchapter to ensure
that the program will be continuously available
on a 24 hour-a-day basis;
an organized and defined system of communica-
tions that provides for public access through a
central emergency communications center using
a single seven digit telephone number for the
service area or an emergency 9-1-1 telephone
system;
the ability to dispatch and coordinate all re-
sources, such as manpower, vehicles and equip-
ment that are essential to the effective and
efficient management of requests for emergency
medical assistance:
an audit and review panel which meets at a
minimum on a quarterly basis;
a formal written policy delineating the proce-
dures for individuals to be trained and/or em-
ployed as emergency medical dispatchers. The
policy shall address:
Provision for EMD selection in a manner that
ensures ability to function in the program;
Provision for initial EMD training and EMD
certification;
Probationary on the job EMD experience:
Provision of continuing professional EMD
education;
Recertification of EMDs functioning in the
program;
Requisite basic medical familiarization includ-
ing CPR and Heimlich maneuver training;
Exposure to EMS field operations and EMS
system familiarization;
a formal risk management program including
written procedures that provide:
(A) The chain of command for establishment of
(A)
£S1
(G)
10:2
NORTH CAROLINA REGISTER
April 17, 1995
154
PROPOSED RULES
policies, procedures, and resolution of con-
flicts relating to the EMD Program;
(B) Administrative procedures and written proto-
cols for resource allocation and alternative
response assignments of emergency response
units;
(C) EMD responsibilities in special situations, such
as disasters, multi-causality incidents, or
situations requiring referral to specialty hot-
lines;
(D) Complete written and recorded documentation
of EMD operations that permit timely medical
audit and review;
(E) Procedures for selection and processing of
cases for EMD audit and review;
(10) adopted and maintains a dispatch coding system
consistent with the incident protocol types in the
EMDPRS which categorizes the problem deter-
mination through the EMDs evaluation of the
problem or situation;
(111 provides, maintains, and upgrades on a regular
basis, all necessary protocols, training equip-
ment, and quality assurance/case review equip-
ment and su pplies required for operation of the
EMD program,
(b) Make application to the Office of Emergency Medical
Services and te re-approved every four years following
initial EMD program approval.
Statutory Authority G.S. 143-514.
SECTION .0400 - EDUCATION AND
PERFORMANCE OF ADVANCED LD7E
SUPPORT
.0408 EMERGENCY MEDICAL DISPATCHER
PERFORMANCE
EMDs educated in approved training programs, when
certified by the Board of Medical Examiners, and while
functioning in an approved Emergency Medical Dispatch
program, may do the following in compliance with the
protocols established in the emergency medical dispatch
priority reference protocol system approved by the program
medical director:
(1") Receive and process calls for medical assistance in
a standardized manner, using the a pproved
EMDPRS protocol to elicit required information
for evaluating, advising, and treating sick or
injured individuals, and dispatching an appropriate
EMS response.
(2) Provide pre-arrival instructions to the patient
through the caller when possible and appropriate
to do so while functioning in compliance with the
EMDPRS.
Statutory Authority G.S. 143-514.
SECTION .0500 - CERTIFICATION AND
APPROVAL REQUIREMENTS FOR ADVANCED
LD7E SUPPORT PERSONNEL
.0506 CERTDJICATION REQUIREMENT:
EMERGENCY MEDICAL DISPATCHER
(a) To become certified as an EMD. a person must meet
the following criteria:
(1) be at least 18 years of age;
(2) be affiliated on a continuous basis with an
emergency medical dispatch program approved
by the Office of Emergency Medical Services;
(3) successfully complete, within one year prior to
application, an American Heart Association
(AHA) Level U C cardiopulmonary resuscitation
(CPR) course or equivalent;
(4) successfully complete, within one year prior to
application, an approved EMD educational
program meeting the requirements of the
"Guidelines for Development and Operation of
Emergency Medical Dispatch Programs" dated
March 1995 incorporated herein by reference.
If the educational program was completed over
one year prior to application, a person must
submit evidence of completion of pertinent
continuing education in emergency medical
dispatch taken in the past year and have the
continuing education a pproved by the Office of
Emergency Medical Services;
(5) successfully complete an evaluation conducted
under the direction of the medical director of the
EMD program assessing the ability to perform
the skills and procedures specified in Rule .0408
of this Subchapter; and be recommended for
certification examination:
(6) pass the EMD written examination administered
by the Office of Emergency Medical Services.
(b) Persons holding current certification equivalent to
EMD with an approved emergency medical dispatch
certification agency or in another state where the educational
and certification requirements have been a pproved for legal
recognition by the Office of Emergency Medical Services
may become certified by:
(1) presenting evidence of such certification for
verification by the Office of Emergency Medical
Services; and
(2) meeting the criteria specified in Subparagraphs
(a)(1). (a)(2). (a)(3). and (a)(5) of this Rule.
(c) Certification obtained through legal recognition shall be
valid for four years or the unexpired term of the certifica-
tion that was used to obtain a certification in this state,
whichever is shorter. All certifications shall be valid for the
period stated on the certificate issued to the applicant by the
Office of Emergency Medical Services. This period shall
not exceed four years. Persons must be recertified by
presenting documentation to the Office of Emergency
Medical Services that they have successfully completed
either of the following options:
OPTION I:
♦
155
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
(1) an ongoing continuing education program under
the direction of the medical director, meeting the
requirements of "Guidelines for Development
and Operation of Emergency Medical Dispatch
Programs" dated March 1995 incorporated
herein by reference.
(2) an EMD performance evaluation conducted
under the direction of the medical director
meeting the requirements of "Guidelines for
Development and Operation of Emergency
Medical Dispatch Programs" dated March 1995
incorporated herein by reference assessing the
ability to perform the skills specified in Rule
.0408 of this Subchapter; and
(3) an EMD written examination administered by
the Office of Emergency Medical Services; or
OPTION n:
£1} the criteria specified in (1) and (2) of OPTION
I of this Rule: and
(2) a written examination following guidelines
established by the Office of Emergency Medical
Services and administered under the direction of
the medical director in compliance with the test
specifications of the state EMD written examina-
tion.
Statutory Authority G.S. 143-514.
SECTION .0600 - ENFORCEMENT
.0601 GROUNDS FOR DENIAL, SUSPENSION,
OR REVOCATION
(a) The Board of Medical Examiners may deny, suspend
or revoke the approval of an ALS program^ EMD program
or sponsor hospital for any of the following reasons:
(1) failure to comply with the requirements as found
in Sections .0200 and .0300 of this Subchapter;
or
(2) obtaining approval through fraud or misrepresen-
tation.
(b) The Board of Medical Examiners may deny, suspend
or revoke the certification of an ALS professional or the
approval of a MICN for any of the following reasons:
(1) failure to comply with the applicable perfor-
mance and certification and approval require-
ments as found in these Rules .0102, .0403,
.0404, .0406, .0407, .0501, .0502, .0503,
.050 4 , and .0505 of this Subchapter ;
(2) obtaining or attempting to obtain certification,
r e o e rtifioation, approval or r e approval through
fraud or misr e pr e s e ntation;
(3) aiding a person in obtaining or attempting to
obtain certification, rocortification, approval or
r e approval through fraud or misr e pr e s e ntation;
f4) failur e — to — perform a pr e oorib e d — procedur e ,
failure to perform a proscribed procedure com
potently or performance of a procedure which is
not within the scope and responsibility of the
oertif i oat e hold e r;
(S) performanc e of a proc e dur e whioh is d e trim e ntal
to the health and safety of a patient;
any felony conviction.
121
£41
(5)
immoral or dishonorable conduct:
making false statements or representations to the
Board of Medical Examiners or the Office of
Emergency Medical Services or willfully con-
cealing of material information in connection
with an a pplication for certification or a pproval;
being unable to perform as an ALS Professional
or MICN with reasonable skill and safety to
patients and the public by reason of illness,
drunkenness, excessive use of alcohol, drugs,
chemicals, or any other type of material or by
reason of any physical or mental abnormality;
unprofessional conduct, including but not limited
to a failure to comply with the rules relating to
the proper function of an ALS Professional or
MICN contained in this Subchapter or the per-
formance of or attempt to perform a procedure
which is detrimental to the health and safety of
a patient or which is beyond the scope and
responsibility of the ALS Professional or MICN;
conviction in any court of a crime involving
moral turpitude, a conviction of a felony, or
conviction of a crime involving the function of
an ALS Professional or MICN;
by false representations obtaining or attempting
to obtain money or anything of value from a
patient;
adjudication of mental incompetency;
lack of professional competence to practice with
a reasonable degree of skill and safety for
patients including but not limited to a failure to
perform a prescribed procedure, failure to
perform a prescribed procedure competently or
performance of a procedure which is not within
the scope of official duties of the ALS Profes-
sional or MICN;
failure to respond within a reasonable period of
time and in a reasonable manner to inquiries
from the Board of Medical Examiners of the
Office of Emergency Medical Services concern-
ing any matter relating to the practice of an ALS
Professional or an MICN;
testing positive for substance abuse by blood,
urine or breath testing while on duty as an ALS
Professional or MICN; or
representing or allowing others to represent that
the ALS Professional or MICN is a physician or
otherwise has a certification or a pproval that the
ALS Professional or MICN does not in fact
have.
Statutory Authority G.S. 143-514.
£6)
(D
m
£21
(10)
an
02)
10:2
NORTH CAROLINA REGISTER
April 17, 1995
156
PROPOSED RULES
.0602 PROCEDURES FOR DENIAL: SUSPENSION
OR REVOCATION
(a) The Board of Medical Examiners may deny, suspend
or revoke the certification of an ALS professional or the
approval of a MICN, sponsor hospital, EMD program or
ALS program in accordance with Article 3A of Chapter
150B.
(b) Notwithstanding Paragraph (a) of this Rule, the Board
of Medical Examiners may summarily suspend the certifica-
tion of an ALS professional, the approval of a MICN,
sponsor hospital, EMD program or ALS program as
specified in G. S. 150B-3(c).
Statutory Authority G.S. 143-514.
SECTION .0800 - FORMS
.0801 REQUIRED FORMS AND DOCUMENTS
(a) The following forms are required for certification or
approval:
(1) Certification Application Form;
(2) ALS Personnel Verification Form.
(b) The following documents are required for educational
and evaluation programs and referenced in the Rules:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
m
"North Carolina EMT-P Curriculum Outline";
"North Carolina EMT-AI Curriculum Outline";
"North Carolina EMT-I Curriculum Outline";
"North Carolina EMT-D Curriculum Outline";
"North Carolina MICN Curriculum Outline";
"Guidelines for Continuing Education and Per-
formance Evaluation of Emergency Medical
Services Advanced Life Support Personnel";
"Guidelines for Reapproval of Mobile Intensive
Care Nurses"; and
"Guidelines for the Selection and Performance
of the Emergency Medical Services Nurse
Liaioon". Liaison";
"Guidelines for Development and Operation of
Emergency Medical Dispatch Programs".
Statutory Authority G.S. 143-514.
SECTION .1000 - MEDICAL CONTROL
.1001 MEDICAL CONTROL PROCEDURES
Each ALS program must have procedures established to
ensure medical control over the medical care rendered in the
ALS program. This shall include, at a minimum:
(1) a designated medical director to carry out the tasks
as specified in Rule .0201(2)(a)-(e) of this Sub-
chapter;
(2) treatment protocols or a pproved emergency medi-
cal dispatch priority reference system (EMDPRS) ;
(3) operational protocols for obtaining medical direc-
tion from the sponsor hospital(s); and
(4) audit and review of the medical care rendered in
the program.
Statutory Authority G.S. 143-514.
SUBCHAPTER 321 - EPINEPHRINE FOR
ADVERSE REACTIONS TO INSECT STINGS
.0003 APPROVAL
A certification by the physician from whom the individual
has received instruction as required in Rule .0002 of this
Subchapter, certifying that such individual has satisfactorily
completed such training program shall be filed with the
N.C. Office of Emergency Medical Services. Upon
recommendation of the Office of Emergency Medical
Services, the Board will approve applicants to administer
epinephrine for the treatment of adverse reactions to insect
stings. This approval will be effective for on e y e ar four
years .
Statutory Authority G.S. 143-509(9).
.0004 FORMS
Forms may be obtained from the Office of Emergency
Medical Services, Division of Facility Services, Department
of Human Resources, 701 Barbour Drive P.O. Box 29530 .
Raleigh, N.C. 33603 27626-0530 .
Statutory Authority G.S. 143-509(9).
CHAPTER 58 - REAL ESTATE COMMISSION
Notice is hereby given in accordance with G.S.
150B-21.2 that the North Carolina Real Estate Com-
mission intends to amend rules cited as 21 NCAC 58A
.0110, .0504 - .0506, .1703, .1707 - .1708, .1710 - .1711;
58E .0103, .0203 - .0204, .0303 - .0305, .0406 - .0407,
.0506; and adopt 58E .0515.
Proposed Effective Date: July 1, 1995.
A Public Hearing will be conducted at 9:00 a. m. on May
3, 1995 at the North Carolina Real Estate Commission,
1313 Navaho Drive, Raleigh, NC.
Reason for Proposed Action:
21 NCAC 58A .0110, .0504 - .0506 - to codify changes in
requirements and procedures concerning broker-in-charge ,
license status, license reinstatement and supervision of
salesman by broker in light of the real estate continuing
education requirement.
21 NCAC 58A .1703, .1707 - .1708, .1710 - .1711 - to
refine and clarify requirements and procedures concerning
continuing education for real estate licensees.
21 NCAC 58E .0103, .0203 - .0204, .0303 - .0305, .0406 -
.0407, and .0506 - to refine and clarify procedures and
standards for the real estate continuing education program.
157
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
21 NCAC 58E .0515 - to codify allowable deviations from
Commission rules regarding conduct of continuing education
courses when the rules conflict with a course sponsor's
obligation to comply with the Americans With Disabilities
Act.
Comment Procedures: Comments regarding the rules may
be made orally or submitted in writing at the public hearing.
Written comments not submitted at the hearing may be sent
to or delivered to Mr. Stephen L. Fussell c/o North Carolina
Real Estate Commission, PO Box 17100, Raleigh, NC
27619-7100, through May 17, 1995.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
SUBCHAPTER 58A - REAL ESTATE BROKERS
AND SALESMEN
SECTION .0100 - GENERAL BROKERAGE
.0110 BROKER-IN-CHARGE
(a) There shall be designated for each firm and branch
office thereof one broker who shall assume responsibility at
such office for:
(1) the proper display of license certificates of the
brokers and salesmen associated with or engaged
on behalf of the firm at such office, auoertn i ning
whether and assuring that each licensee em-
ployed at the office has complied with Rules
.OSC^ .0504 and .0506 of this Subchapter;
(2) the proper notification to the Commission of any
change of business address or trade name of the
firm and the registration of any assumed busi-
ness name adopted by the firm for its use;
(3) the proper conduct of advertising by or in the
name of the firm at such office;
(4) the proper maintenance at such office of the trust
or escrow account of the firm and the records
pertaining thereto;
(5) the proper retention and maintenance of records
relating to transactions conducted by or on
behalf of the firm at such office;
(6) the proper supervision of salesmen associated
with or engaged on behalf of the firm at such
office in accordance with the requirements of
Rule .0506 of this Subchapter; and
(7) the verification to the Commission of the experi-
ence of any salesman at such office who may be
applying for licensure as a broker.
No broker shall be broker-in-charge of more than one
office or branch office.
(b) When used in this Rule, the term:
(1) "Branch Office" means any office in addition to
the principal office of a broker which is operated
in connection with the broker's real estate
business; and
(2) "Office" means any place of business where acts
are performed for which a real estate license is
required.
(c) A broker-in-charge must continually maintain his
license on active status.
(d) Each broker-in-charge shall notify the Commission in
writing of any change in his status as broker-in-charge
within 10 days following the change. Within 10 days
following termination of his supervisory responsibilities over
any salesman, the broker-in-charge shall provide the
salesman, in a form prescribed by the Commission, an
accurate written statement regarding the number and type of
properties listed, sold, bought, leased or rented for others
by the salesman while under the supervision of the broker-
in-charge.
Statutory Authority G.S. 93A-3(c).
SECTION .0500 - LICENSING
.0504 ACTIVE AND INACTIVE LICENSE STATUS
(a) Except for licenses that have expired or that have been
revoked, suspended or surrendered, all licenses issued by
the Commission shall be designated as being either on active
status or inactive status. The holder of a license on active
status may engage in any activity requiring a real estate
license and may be compensated for the provision of any
lawful real estate brokerage service. The holder of a license
on inactive status may not engage in any activity requiring
a real estate license, including the referral for compensation
of a prospective seller, buyer, landlord or tenant to another
real estate licensee or any other party. A licensee holding
a license on inactive status must renew such license and pay
the prescribed license renewal fee in order to continue to
hold such license. The Commission may take disciplinary
action against a licensee holding a license on inactive status
for any violation of Chapter 93A of the General Statutes of
North Carolina or any rule promulgated by the Commission,
including the offense of engaging in an activity for which a
license is required while a license is on inactive status.
(b) Upon initial licensure, a salesman's license shall be
assigned by the Commission to inactive status and the
license of a broker or corporate broker shall be assigned to
active status. The license of a broker, salesman or corpo-
rate broker shall be assigned by the Commission to inactive
status upon the written request of the licensee. A sales-
man's license shall be assigned by the Commission to
inactive status by the Commission when the salesman is not
under the active, personal supervision of a broker-in-charge.
A corporate broker's license shall be assigned by the
Commission to inactive status when the corporation does not
have a principal broker. A broker or salesman shall also be
assigned to inactive status if, upon the second renewal of his
license following initial licensure, or upon any subsequent
renewal, he has not satisfied the continuing education
requirement described in Rule .1702 of this Subchapter.
fe) — A salesman's inactive licen s e s hall bo assigned to
10:2
NORTH CAROLINA REGISTER
April 17, 1995
158
PROPOSED RULES
active status upon receipt by tho Commission of tho properly
completed form prooorib e d in Rul e .0506(b) of thi s S e otion,
upon pr e o e ntation of e vidonoo that h e has obtained any
continuing education that may bo required by Rule . 1703 of
this Subchapter, and upon submission of an affidavit, on a
form prooorib e d by th e Commiooion, dosoribing any involv e
mont in roal estate brok e rag e th e oal e oman may hav e had
while his license was inactive. — A broker's inactive lioonso
shall bo assigned to active status upon tho written request of
the broker on a form proooribed by th e Commiooion, upon
presentation of e vid e nc e that ho has obtain e d any continuing
education that may bo required by Rulo .1703 of this
Subchapter, and upon submission of an affidavit, on a form
preooribod by th e Commission, d e ooribing any involv e m e nt
in real e state brok e rag e the broker may havo had while his
license was inactive. — A corporate broker's inactive lioonso
shall bo assigned to active status upon designation in writing
of a principal broker or upon r e instat e m e nt of tho e xpir e d
l i c e ns e of th e loot designated prinoipal brok e r and upon
submission by tho principal broker of an affidavit, on a
form proscribed by tho Commission, de s cribing any involve
mont in real e state brokerag e the corporation ma)' have had
while ito lioonso was inactiv a -
te) A salesman with an inactive license who desires to
have such license placed on active status must comply with
the procedures prescribed in Rule .0506 (b) of this Section.
£d) A broker with an inactive license who desires to have
such license placed on active status shall file with the
Commission a request for license activation on a form
prescribed by the Commission containing identify inn
information about the broker, a list of Commission-approved
continuing education courses completed by. the broker within
the previous 30 days, a statement that the broker has
satisfied the continuing education requirements prescribed by
Rule .1703 of this Subchapter, the date of the request, and
the signature of the broker. Upon the mailing or delivery
of this form, the broker may engage in real estate brokerage
activities requiring a license; however, if the broker does
not receive from the Commission a written acknowledge-
ment of the license activation within 30 days of the date
shown on the form, the broker shall immediately terminate
his real estate brokerage activities pending receipt of the
written acknowledgement from the Commission. If the
broker is notified that he is not eligible for license activation
due to a continuing education deficiency, the broker must
terminate all real estate brokerage activities until such time
as the continuing education deficiency is satisfied and a new
request for license activation is submitted to the Commis-
sion.
Statutory Authority G.S. 93A-3(c); 93A-4(d); 93A-4A; 93A-6.
.0505 REINSTATEMENT OF EXPIRED LICENSE
(a) Licenses expired for not more than 12 months may be
reinstated upon proper application and payment of the
twenty-five dollar ($25.00) renewal fee plus five dollar
($5.00) late filing fee. In order to reinstate such license on
active status for a license period beginning on or after July
1, 1995, the applicant shall also present evidence satisfac-
tory to the Commission of having obtained such continuing
education as is required by Rule . 1703 of this Subchapter to
change an inactive license to active status , except that tho
time during which tho lioonso was oxp i rod shall also count
ao inactiv e tim e for th e purpos e of determining th e amoun t
of continuing e duoation e l e ctiv e credit hours required . A
person reinstating such a license on inactive status shall not
be required to have obtained any continuing education in
order to reinstate such license; however, in order to subse-
quently change his reinstated license from inactive status to
active status, the licensee must satisfy the continuing
education requirement prescribed in Rule .1703 of this
Subchapter and th e tim e during which the lioono e was
expired shall also count ao inactive time for tho purpooo of
determining tho amount of continuing education elective
credit hours required .
(b) Reinstatement of licenses expired for more than 12
months may be considered upon proper application and
payment of a thirty dollar ($30.00) fee. Applicants must
satisfy the Commission that they possess the current knowl-
edge, skills and competence necessary to function in the real
estate business in a manner that protects and serves the
public interest. In this regard, the Commission may require
such applicants to complete real estate education and/or pass
the license examination.
Statutory Authority G.S. 93A-3(c); 93A-4(c),(d); 93A-4A.
.0506 SALESMAN TO BE SUPERVISED BY
BROKER
(a) A salesman' s license is valid salesman may engage in
or hold himself out as engaging in activities requiring a real
estate license only while his license is on active status and
he is supervised by the broker-in-charge of the real estate
firm or office where the salesman is engaged in tho business
of a sal eo man associated . A salesman shall not act as or
hold himself out to b e a brok e r, nor shall he aot as a
oal e oman outrid e th e sup e rvision of th e brok e r in charg e of
tho firm or office whore tho salesman is employed.
(b) Upon a salesman's association with a real estate
broker or brokerage firm, the salesman and the broker-in-
charge of the office where the salesman will be engaged in
the real estate business of a real estate salesman shall
immediately file with the Commission a salesman supervi-
sion notification on a form prescribed by the Commission
containing th e sal e oman'o nam e and r e sid e nc e address, th e
name of identifying information about the salesman and the
broker-in-charge, tho name of tho firm and tho address of
th e offic e with which th e broker in ohargo is associated, a
statement from the broker-in-charge certifying that he will
supervise the salesman in the performance of all acts for
which a license is required, the date that the broker-in-
charge assumes responsibility for such supervision, and the
signatures of the salesman and broker-in-charge. If the
salesman is on inactive status at the time of associating with
a broker or brokerage firm, the salesman and broker-in-
charge shall also file, along with the salesman supervision
159
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
notification, the salesman's request for license activation on
a form prescribed by the Commission containing identifying
information about the salesman, a list of Commission-
approved continuing education courses completed by the
salesman within the previous 30 days, the salesman's
statement that he has satisfied the continuing education
requirements prescribed by Rule .1703 of this Subchapter,
the date of the request, and the signatures of the salesman
and the salesman's proposed broker-in-charge. Upon
mailing or delivering the properly oompl e tod form to th e
Commiooion by the broker in oharg e , th e salesman named
in the form may engage in the businooa of a salesman under
the supervision of the broker in charge ponding acknowlodg
m e rit from th e Commiosion of reo e ipt of auoh form; how -
e ver, in th e e v e nt suoh written acknowl e dgm e nt from th e
the broker-in-charge.
Statutory Authority G.S. 93A-2(b); 93A-3(c).
SECTION .1700 - MANDATORY
CONTINUING EDUCATION
.1703 CONTINUING EDUCATION FOR
LICENSE ACTIVATION
(a) On and aft e r July 1, 19 9 5, a A broker or salesman
requesting to change an inactive license to active status on
or after the licensee's second license renewal following his
initial licensure shall be required to demonstrate completion
of continuing education as described in th i n Rul e . — The
licensee must hav e oompletod, oinoe the beginning of th e
Commission is not received by the broke r in charge within license period immediately preceding the date of request for
thirty calendar days following the date shown in the form,
th e brok e r in oharge shall oauoe th e sal e sman to imm e diately
cease any furth e r aotivity for whioh a real estat e lio e no e is
required ponding receipt of the written acknowledgment
from the Commissio Br Upon the mailing or delivery of the
required formfs) by. the broker-in-charge. the salesman may
engage in real estate brokerage activities requiring a license
under the supervision of the broker-in-charge ; however, if
the salesman and broker-in-charge do not receive from the
Commission a written acknowledgment of the salesman
supervision notification and, if a ppropriate, the request for
license activation, within 30 days of the date shown on the
form, the broker-in-charge shall immediately terminate the
salesman's real estate brokerage activities pending receipt of
the written acknowledgment from the Commission. If the
salesman and broker-in-charge are notified that the salesman
is not eligible for license activation due to a continuing
education deficiency, the broker-in-charge shall cause the
salesman to immediately cease all activities requiring a real
estate license until such time as the continuing education
deficiency is satisfied and a new salesman supervision
notification and request for license activation is submitted to
the Commission.
(c) A broker-in-charge who certifies to the Commission
that he will supervise a licensed salesman shall actively and
personally supervise the salesman in a manner which would
r e a s onabl e aoour e reasonably assures that the salesman
performs all acts for which a real estate license is required
in accordance with the real estate license law Real Estate
License Law and Commission rules. A supervising broker
who fails to supervise a salesman as prescribed in this Rule
may be subject to disciplinary action by the Commission.
(d) Upon termination of his supervision of a salesman, a
broker-in-charge shall immediately:
(1) notify the Commission in writing setting forth
the date of termination; and
(2) give the salesman, in a form prescribed by the
Commission, an accurate written statement
regarding the number and type of properties
listed, sold, bought, leased or rented for others
by the salesman while under the supervision of
licen s e activation, both a mandato r y update course and a
numb e r of hours in approved elective ooureee to b e deter
min e d according to Paragraph (b) or (c) of this Rule,
whichever is appropriate.
(b) If the mandatory update course was completed during
th e imm e diat e pr e c e ding l i o e no e period, the licensee must
also have obtained, einoe tho beginning of the imm e diate
preceding license period, four credit hour s in app r oved
elective courses for oach license period or portion thereof
that the license has boon continuously inaotiv e , up to a
maximum of 12 hours. — None of th e electiv e cours e or e dit
hours obtained to satisfy this requirement may bo credited
toward tho continuing education requirement for tho current
license p e riod.
£b) If the inactive licensee's license has properly been on
active status at any time since the preceding July j^ the
licensee is considered to be current with regard to continu-
ing education and no additional continuing education is
required to activate the license.
(c) If tho mandatory update course was completed during
tho current license period, tho licensee must also have
obtain e d, oino e th e b e ginning of th e imm e diate pr e c e ding
lio e no e p e riod, — four or e dit hours in approv e d e l e ctiv e
courses fo r each license period o r portion thereof that tho
license has boon continuously inactive, up to a maximum of
16 houro. provid e d that th e minimum number of elective
cours e or e dit hours r e quir e d oino e th e b e ginning of th e
immediate preceding license period shall bo eight hours.
None of those elective course credit hours may bo credited
toward th e oontinuing e ducation r e quir e ment for th e ourr e nt
lioenoe period; however, tho update course oredit hours shall
bo cred i ted toward tho continuing education requirement for
tho current license period.
(c) If the inactive licensee's license has not been on active
status since the preceding July 1. the licensee must make up
any deficiency in his continuing education record for the
previous two license periods. Any deficiency may be made
up by completing, during the current license period,
approved continuing education elective courses; however,
such courses will not be credited toward the continuing
education requirement for the current license period. In
10:2
NORTH CAROLINA REGISTER
April 17, 1995
160
PROPOSED RULES
addition, if the licensee's deficiency included the mandatory
update course for the immediate preceding license period,
the licensee must also complete, during the current license
period, the mandatory update course for the current license
period; however, such course shall be credited toward the
continuing education requirement for the current license
period. Regardless of the length of time a license has been
on inactive status, the maximum amount of continuing
education credit hours required to activate that license shall
be 20 hours. When crediting elective courses for purposes
of making up a continuing education deficiency, the maxi-
mum number of credit hours that will be awarded for any
course is four hours.
(d) For th e purpoo e of oatiofying tho olootivo ooureo cr e dit
hour r e quir e m e nt dooorib e d in Paragraphs (b) and (o) of this
Rulo, tho maximum number of orodit hours that shall bo
awarded for any s ingle course is four hours.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.1707 ELECTIVE COURSE CARRY-OVER
CREDIT
If a lioono ee — fully oatiofioo the continu i ng e duoation
elective? requirement for a particular license period and then
take s on additional approved continuing education elective
oouroo(B) in that same lioono e period, th e oreditable houro
tak e n in th e additional oouro e fo) may b e appli e d toward
satisfaction of tho continuing eduoation elective r equirement
for the next succeeding license period. A maximum of four
hours of continuing education credit for an a pproved elective
course taken during the current license period may be
carried over to satisfy the continuing education elective
requirement for the next following license period if the
licensee receives no continuing education elective credit for
the course toward the elective requirement for the current
license period or the previous license period. However, if
a continuing education elective course is used to wholly or
partially satisfy the elective requirement for a part i cu l ar the
current or previous license period, then any excess hours
completed in such course which are not needed to satisfy the
four-hour elective requirement for that license period may
not be carried forward and applied toward the elective
requirement for the next ouooocding following license
period.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.1708 EQUIVALENT CREDIT
(a) A licensee may request that the Commission award
continuing education credit for a course taken by the
licensee that is not approved by the Commission, or for
some other real estate education activity, by making such
request on a form prescribed by the Commission and
submitting a nonrefundable evaluation fee of fifty thirty
dollars ($50.00) ($30.00) for each request for evaluation of
a course or real estate education activity. Such requests and
all supporting documents, with the exception of applications
from instructors of continuing education courses desiring
equivalent credit for teaching Commission-approved continu-
ing education courses, must be received by the Commission
at least 60 days prior to the expiration of the licensee's
current license.
(b) The Commission may award continuing education
elective credit for satisfactory completion of an unapproved
course which the Commission finds equivalent to the
elective course component of the continuing education
requirement set forth in Section .0300 of Subchapter 58E.
Completion of an unapproved course may serve only to
satisfy the elective requirement and cannot be substituted for
completion of the mandatory update course.
(c) Real estate education activities, other than teaching a
Commission-approved course, which may be eligible for
credit include, but are not limited to: developing a
Commission-approved elective continuing education course,
authorship of a published real estate textbook; and author-
ship of a scholarly article, on a topic acceptable for continu-
ing education purposes, which has been published in a
professional journal. Each activity for which continuing
education credit is requested must have been completed
within the current license period. The Commission may
award continuing education elective credit for activities
which the Commission finds equivalent to the elective
course component of the continuing education requirement
set forth in Section .0300 of Subchapter 58E. No activity
other than teaching a Commission-developed mandatory
update course shall be considered equivalent to completing
the mandatory update course.
(d) The Commission may award credit for teaching the
Commission-developed mandatory update course and for
teaching an approved elective course. Credit for teaching
an approved elective course shall be awarded only for the
license period in which the instructor teaches the course for
the first time. Credit for teaching a Commission-developed
mandatory update course may be awarded for each licensing
period in which the instructor teaches the course. The
amount of credit awarded to the instructor of an approved
continuing education course shall be the same as the amount
of credit earned by a licensee who completes the course.
The instructor must provide proof that he taught the course
within the current license period. Licensees who are
instructors of continuing education courses approved by the
Commission shall not be subject to the fifty thirty dollar
($50.00) ($30.00) evaluation fee when applying for continu-
ing education credit for teaching an approved course. No
credit toward the continuing education requirement shall be
awarded for teaching a real estate prelicensing course.
(e) No carry-over credit to a subsequent license period
shall be awarded for taking an unapproved continuing
education course or for any real estate education activity
other than teaching an approved elective course.
(f) A licensee completing a real estate a ppraisal
prelicensing. precertification or continuing education course
a pproved by the North Carolina Appraisal Board may obtain
real estate continuing education elective credit for such
course by submitting to the Commission a written request
for equivalent continuing education elective credit accompa-
161
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
nied by a nonrefundable processing fee of twenty dollars
($20. OCT) and a copy of the certificate of course completion
issued by the course sponsor for submission to the North
Carolina Appraisal Board. Such appraisal course must have
been completed during the license period for which the
request for equivalent credit is made.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.1710 DENIAL OR WITHDRAWAL OF
CONTINUING EDUCATION CREDIT
(a) The Commission may deny continuing education
credit claimed by a licensee or reported by a course sponsor
for a licensee, and may withdraw continuing education
credit previously awarded by the Commission to a licensee
upon finding that:
(1) The licensee or course sponsor provided incor-
rect or incomplete information to the Commis-
sion concerning continuing education completed
by the licensee;
(2) The licensee failed to comply with either the
attendance requirement established by Rule
. 1705 of this Section or the student participation
standards set forth in Rule .0511 of Subchapter
58E; or
(3) The licensee was mistakenly awarded continuing
education credit due to an administrative error.
(b) When continuing education credit is denied or
withdrawn by the Commission under Paragraph (a) of this
Rule, the licensee remains responsible for satisfying the
continuing education requirement. However, when an
administrative error or an incorrect report by a course
sponsor results in the denial or withdrawal of continuing
education credit for a licensee, the Commission may, upon
request of the licensee, grant the licensee an extension of
time to satisfy the continuing education requirement.
(c) A licensee who obtains or attempts to obtain continu-
ing education credit through misrepresentation of fact,
dishonesty or other improper conduct shall be subject to
disciplinary action pursuant to G.S. 93A-6.
Statutory Authority G.S. 93A-3(c); 93A-4A.
in the state where the course was taken . Crodit for such
e ducat i on shall bo awarded only upon r e o e ipt of verification
provid e d by tho licensing ag e ncy in th e l i c e ns ee 's stat e of
residence or by the official course sponsor that the licen s ee
has completed tho number of hours of continuing education
for which th e licensee deoir e o th e Commission to award
credit. To obtain credit for a continuing education course
completed in another state and not a pproved by the Commis-
sion, the licensee must submit a written request for continu-
ing education credit accompanied by a nonrefundable
processing fee of twenty dollars ($20.00) per course and
evidence satisfactory to the Commission that the course was
completed and that the course was a pproved for continuing
education credit by the real estate licensing agency in the
licensee's state of residence or in the state where the course
was taken.
(b) When requesting to change an inactive license to
active status, or when applying for reinstatement of a license
expired for not more than 12 months, a nonresident broker
or salesman may take continuing education courses approved
by the real estate licensing agency in his state of residence
or another state to fully satisfy the continuing education
requirements described in Rules .0505 and . 1703 of this
Subchapter.
(c) If tho licensing agency in tho licensee's state of
resid e nce does not approve courses for real estate continuing
e ducation, or if tho licensee io not lic e ns e d in his stat e of
residence, tho licensee In addition to the options described
in Paragraphs (a) and (b) of this Rule for satisfying the
continuing education requirement, a nonresident licensee
may request that the Commission award continuing educa-
tion credit for a course not approved by the Commission or
for related educational activities as provided in Rule .1708
of this Section.
(d) No carry-over credit to a subsequent license period
shall be awarded for a course taken in another state that has
not been a pproved by the North Carolina Real Estate
Commission as an elective course.
Statutory Authority G.S. 93A-3(c); 93A-4A.
SUBCHAPTER 58E - REAL ESTATE
CONTINUING EDUCATION
.1711 CONTINUING EDUCATION REQUD1ED
OF NONRESIDENT LICENSEES
(a) Real estate brokers and salesmen licensed in North
Carolina but residing in another state at the time they apply
for license renewal who wish to renew their licenses on
active status for a license period beginning on or after July
1, 1995 may fully satisfy the continuing education require-
ment eith e r by completing^ within one year preceding
license expiration, either the Commission-prescribed update
course plus four classroom hours of instruction in original approval will not bo accepted botwoon April 1 and
SECTION .0100 - UPDATE COURSE
.0103 APPLICATION FOR ORIGINAL APPROVAL
An entity seeking original approval to sponsor a
Commission-developed update course must make application
on a form prescribed by the Commission. Beginning — m
1995, auoh applications must b e submitt e d prior to April 1
or after Juno 30 of any calendar year. — Applications for
Commission-approved continuing education elective courses
or by oomploting eight classroom hours of instruction in
courses approved for continuing education credit by the real
estate licensing agency in the licensee's state of residence or
Jun e 30 of any oal e ndar y e ar after 1994. The applicant
must submit a nonrefundable fee of one hundred dollars
($100.00) in the form of a certified check , bank check or
money order payable to the North Carolina Real Estate
10:2
NORTH CAROLINA REGISTER
April 17, 1995
162
PROPOSED RULES
Commission; provided, however, that no fee is required if
the entity making application is a community college, junior
college, college or university located in this State and
accredited by the Southern Association of Colleges and
Schools^ or is an agency of federal, state or local govern-
ment . An applying entity that is not a resident of North
Carolina shall also file with the application a consent to
service of process and pleadings.
Statutory Authority G.S. 93A-3(c); 93A-4A.
SECTION .0200 - UPDATE COURSE
INSTRUCTORS
.0203 APPLICATION AND CRITERIA FOR
ORIGINAL APPROVAL
(a) A person seeking original approval as an update
course instructor must make application on a form pre-
scribed by the Commission. B e ginning in 1995, euoh
applications must bo submitted prior to April 1 or aftor Juno
30 of any calendar yoar. Applications for original approval
will not b e aoo e ptod botwoon April 1 and Juno 30 of any
oalondar yoar aftor 1994. An applicant who is not a resident
of North Carolina shall also file with the application a
consent to service of process and pleadings. No application
fee is required. All required information regarding the
applicant's qualifications must be submitted.
(b) The applicant must be truthful, honest and of high
integrity.
(c) The applicant must be qualified under one of the
following standards:
(1) Possession of a baccalaureate or higher degree
with a major in the field of real estate.
(2) Possession of a current North Carolina real
estate broker license, three years active full-time
experience in real estate brokerage within the
previous ten years, and 30 classroom hours of
real estate education, excluding prelicensing
education, within the past three years, such
education covering topics which are acceptable
under Commission rules for continuing education
credit.
(3) Possession of a current North Carolina real
estate broker license and experience teaching at
least ten real estate prelicensing courses within
the previous five years.
(4) Possession of a license to practice law in North
Carolina and three years experience in law
practice within the previous 10 years, with a
substantial emphasis on real estate practice.
(5) Possession of qualifications found by the Com-
mission to be equivalent to one or more of the
above standards,^ provided that the requirement
for a current North Carolina real estate broker
license shall be waived only for applicants who
qualify under Subparagraph (eld) or £4} of this
Rule .
(d) The applicant must possess good teaching skills as
demonstrated on a videotape portraying the instructor
teaching a live audience. The applicant must submit for
Commission review a videotape in a format prescribed by
the Commission. The videotape must be 45-60 minutes in
length and must depict a continuous block of instruction on
a single real estate or directly related topic. The videotape
must be unedited, must show at least a portion of the
audience, and must have visual and sound quality sufficient
to enable reviewers to clearly see and hear the instructor.
The videotape must have been made within the previous
three years. The videotape must demonstrate that the
instructor possesses the teaching skills described in Rule
.0509 of this Subchapter.
(e) An applicant shall be exempt from qualifying under
Paragraphs (c) and (d) of this Rule if he possesses a current
North Carolina real estate broker license and a current
designation as a Designated Real Estate Instructor (DREI)
granted by the Real Estate Educators Association.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.0204 RENEWAL OF APPROVAL
Commission approval of update course instructors expires
on the next December 31 following issuance of approval,
except that approval of instructors approved prior to January
1, 1995 shall expire on December 31, 1995. In order to
assure continuous approval, a pproved instructors must file
applications for renewal of approval must bo filed on a form
prescribed by the Commission on or before December 1
immediately preceding expiration of their approval.
Applicants must satisfy the criteria for original approval,
with the exception of the requirement stated in Rule
.0203(d) of this Section, in order to renew their approval.
Statutory Authority G.S. 93A-3(c); 93A-4A.
SECTION .0300 - ELECTIVE COURSES
.0303 APPLICATION FOR ORIGINAL
APPROVAL
An entity seeking original approval of a proposed elective
course must make application on a form prescribed by the
Commission. Beginning in 19 9 5, ouoh applications must b e
submitted prior to April 1 or aftor Jun e 30 of any oalondar
year. Applications for original approval will not be ac-
cepted between April 1 and June 30 of any calendar year^
provided that this restriction shall not app ly when an
a pplicant is seeking approval to conduct a course for which
a pproval has already been obtained by another sponsor, after
1994. The applicant must submit a nonrefundable fee of
one hundred dollars ($100.00) per course in the form of a
certified check , bank chock or money ordo* payable to the
North Carolina Real Estate Commission; provided, how-
ever, that no fee is required if the entity making application
is a community college, junior college, college or university
located in this State and accredited by the Southern Associa-
tion of Colleges and School or is an agency of federal,
state or local government . The application shall be accom-
163
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
I
*
panied by a copy of the course plan or instructor's guide for
the course and a copy of materials that will be provided to
students. An applying entity that is not a resident of North
Carolina shall also file with the application a consent to
service of process and pleadings.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.0304 CRITERIA FOR ELECTIVE COURSE
APPROVAL
The following requirements must be satisfied in order to
obtain approval of a proposed elective course:
(1) The applicant must submit all information required
by the Commission and pay the application fee, if
applicable.
(2) The applicant must satisfy any of the requirements
of Section .0400 of this Subchapter relating to the
qualifications or eligibility of course sponsors.
(3) The subject matter of the course must satisfy the
elective course subject matter requirements set
forth in Rule .0305 of this Section and all infor-
mation to be presented in the course must be
current and accurate.
(4) The course must involve a minimum of two
classroom hours of instruction on acceptable
subject matter. A classroom hour consists of 50
minutes of instruction and 10 minutes of break
time.
(5) The applicant and the continuing education coordi-
nator required by Rule .0405 of this Subchapter
must be truthful, honest and of high integrity. In
this regard, the Commission may consider the
reputation and character of any owner, officer and
director of any corporation, association or organi-
zation applying for sponsor approval.
(6) The proposed instructors) for the course must
possess the qualifications described in Rule .0306
of this Section.
(7) The course must be one that will be conducted by
a qualified instructor who will be able to interact
directly either in person or by interactive televi-
sion with all students at all times during the
course. The course may be conducted through the
use of interactive television which permits continu-
ous mutual communication between the instructor
and all students, continuous observation of the
instructor by all students, and continuous observa-
tion of all students by the instructor. The use of
media-based instruction such as videotape, remote
non-interactive television, computer programs or
similar types of instruction may be employed on a
limited basis to enhance or supplement personal
instruction. No portion of the course may consist
of correspondence instruction.
(8) Th e oouro e plan or instruotor'o guid e muot provide
for the uso of instructional methods and instruo
tional aids that are appropriate in view of the
subject matter and must clearly identify the loam
tag objootiv e o for th e oouro e . The a pplicant must
submit an instructor guide that includes:
(a) a detailed course outline.
(b) the amount of time to be devoted to each major
topic and to breaks.
(c) the learning objective(s) for each major topic,
and
(d) the instructional methods and instructional aids
that will be utilized in the course.
The proposed time allotments must be appropriate
for the proposed subject matter to be taught.
Unless the a pplicant can demonstrate that straight
lecture is the most effective instructional method
for the course, the instructor guide must provide
for the use of an a ppropriate variety of instruc-
tional methods and instructional aids intended to
enhance student attentiveness and learning.
Examples of instructional methods and instruc-
tional aids that may be appropriate include, but
are not limited to, class discussion, role-playing,
in-class work assignments, overhead transparen-
cies and videotape.
(9) The course must include handout materials for
students unless the applicant can demonstrate that
such materials are either inappropriate or unneces-
sary for the course. Such materials must ad e
quatoly oovor the topics described in the course
plan or in s tructor's guide and must be current,
accurate, grammatically correct, logically orga-
nized and produced in a manner that reflects
reasonable quality.
(10) Either the instructor guide or the student materials
must describe, in narrative form, the details of the
substantive information to be presented in the
course. The substantive information to be pre-
sented must be provided in sufficient detail to
demonstrate that the information is current, accu-
rate, complete, and otherwise a ppropriate.
(11) If an a pplicant proposes to use copyrighted materi-
als in the course, such materials must be used in
a form approved by the copyright holder. If any
copyrighted material is to be duplicated by the
applicant for use in the course, the sponsor must
have the specific permission of the copyright
holder.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.0305 ELECTIVE COURSE SUBJECT MATTER
(a) Elective courses must cover a real estate topic and
must directly contribute to accomplishment of the primary
purpose of mandatory continuing education, which is to help
assure that real estate licensees possess the knowledge, skills
and competence necessary to function in the real estate
business in a manner that protects and serves the public
interest. The knowledge or skills taught in an elective
10:2
NORTH CAROLINA REGISTER
April 17, 1995
164
PROPOSED RULES
course must enable licensees to better serve real estate
consumers and the subject matter must be directly related to
real estate practice. Examples of acceptable subject matter
include, but are not limited to: Real property law; agency
law; real estate contracts; land use controls; environmental
protection laws; real estate economics and markets; real
estate finance, investment or appraisal; property manage-
ment; real estate construction or development; commercial
real estate brokerage; taxation of real estate investments; the
Real Estate License Law and Commission rules; and other
similar topics. Examples of subject matter that is not
acceptable include, but are not limited to: Real estate sales
training; real estate brokerage management; business
administration or management; general office and computer
skills; success training; motivational training; personal
development; time management; and other similar topics.
(b) If there are unique North Carolina laws, rules or
customary practices that are relevant to a topic being
addressed in an elective course, and if the course is to be
conducted in North Carolina or primarily for the benefit of
North Carolina licensees, then the course must accurately
and completely address such North Carolina laws, rules or
practices.
Statutory Authority G.S. 93A-3(c); 93A-4A.
SECTION .0400 - GENERAL
SPONSOR REQUIREMENT
.0406 COURSE ROSTERS, COMPLETION
CERTIFICATES AND EVALUATIONS
(a) Course sponsors and instructors must complete ef
have students complete, as appropriate, a roster of all real
estate licensees enrolled in an approved continuing education
course and a course completion eafd report for each licensee
who satisfactorily completes the course according to the
criteria in 21 NCAC 58A . 1705 and who desires continuing
education credit for the course. Sponsors may allow
students to complete portions of the course completion
report, but sponsors will be held accountable for the
accuracy of all information on such report . Sponsors must
submit these documents to the Commission within fifteen
calendar days following the course, but in no case later than
June 15 for courses conducted prior to that date. These
documents shall be completed on forms and in accordance
with instructions prescribed by the Commission.
(b) Course sponsors and instructors must provide licens-
ees enrolled in each continuing education course an opportu-
nity to complete an evaluation of each approved continuing
education course: — Th e e valuation shal l b e oompl e t e d on a
form and in accordance with instructions prescribed by the
Commission. Sponsors must submit the completed evalua-
tion forms to the Commission within fifteen calendar days
following the course, but in no case later than June 15 for
any course completed prior to that date.
(c) Course sponsors and instructors shall provide each
licensee who satisfactorily completes an approved continuing
education course according to the criteria in 21 NCAC 58 A
.1705 a course completion certificate on a form and in
accordance with instructions prescribed by the Commission.
Sponsors must provide the certificates to licensees within
fifteen calendar days following the course, but in no case
later than June 15 for any course completed prior to that
date. The certificate is to be retained by the licensee as his
proof of having completed the course.
(d) Course sponsors shall advise the Commission in
writing when a licensee in attendance at a continuing
education course does not comply with the Commission's
attendance or student participation standards.
Statutory Authority G.S. 93A-3(c); 93A-4A.
.0407 PER STUDENT FEE
Following completion of any approved continuing educa-
tion update or elective course, the sponsor must submit to
the Commission, along with the roster, course completion
oardc reports and evaluation forms required to be submitted
by Rule .0406 of this Section, a fee in the amount of five
dollars ($5.00) for each licensee who satisfactorily com-
pletes the course according to the criteria in 21 NCAC 58 A
. 1705. This fee is not required if the sponsor is a commu-
nity college, junior college, college or university located in
North Carolina and accredited by the Southern Association
of Colleges and Schools.! or is an agency of federal, state or
local government . This fee shall be paid by check payable
to the North Carolina Real Estate Commission. A separate
check is required for each separate class session.
Statutory Authority G.S. 93A-3(c); 93A-4A.
SECTION .0500 - COURSE OPERATIONAL
REQWREMENTS
.0506 CLASSES OPEN TO ALL LICENSEES
All class sessions of approved continuing education
courses must be open to all licensees on a first-come/first-
served basisi provided that the sponsor of a course which
has a bona fide education or experience prerequisite, such
as an advanced course leading to a special real estate
designation, may refuse admission to a licensee not satisfy-
ing such prerequisite . Real e stat e lio e noooo, compani e s,
franchi s es, company owned schools or trade organizations
approved by the Commiaflion as course sponsors must afford
all lio e noooo an equal opportunity to e nroll in oaoh ooooion
of an approv e d oouro e . — Couro e o may not b e promot e d or
conducted in ouch a manner as would effectively oxoludo
lioonBoofl who aye not affiliated in some manner with the
oponoor. An a pproved sponsor may contract with an
organization such as a real estate firm, franchise or trade
organization to conduct approved continuing education
courses for licensees affiliated with such organization, but
the sponsor must allow licensees not affiliated with the
organization to enroll in any class session on a first-
come/first-served basis.
Statutory Authority G.S. 93A-3(c); 93A-4A.
165
NORTH CAROLINA REGISTER
April 17, 1995
10:2
PROPOSED RULES
.0515 ACCOMMODATIONS FOR PERSONS
WITH DISABILITIES
Course sponsors may deviate from Commission rules
concerning the conduct of continuing education courses,
such as rules addressing classroom facilities, minimum class
size and instructional methods, as may be necessary in order
for the sponsor to comply with the Americans with Disabili-
ties Act or other laws requiring such sponsors to accommo-
date persons with disabilities. A sponsor providing a special
accommodation for a licensee with a disability that requires
the sponsor to deviate from Commission rules shall notify
the Commission in writing of the accommodation at the time
reports are submitted for the class session attended by the
licensee.
Statutory Authority G.S. 93A-3(c); 93A-4A.
I
I
10:2 NORTH CAROLINA REGISTER April 17, 1995 166
LIST OF RULES CODIFIED
J. he List of Rules Codified is a listing of rules that were filed with OAH in the month indicated.
Key
Citation
= Title, Chapter, Subchapter and Rule(s)
AD
= Adopt
AM
= Amend
RP
= Repeal
With Chgs
■=■ Final text differs from proposed text
Corr
— Typographical errors or changes that requires no rulemaking
Eff. Date
= Date rule becomes effective
Temp. Expires
= Rule was filed as a temporary rule and expires on this date or 180 days
NORTH CAROLINA ADMINISTRATIVE CODE
MARCH 95
t
[TLE
DEPARTMENT
10
Human Resources
11
Insurance
12
Justice
13
Labor
15A
Environment, Health, and
Natural Resources
17
Revenue
[TLE
DEPARTMENT
19A
Transportation
21
Occupational Licensing Boards
14 - Cosmetic Art Examiners
18 - Electrical Contractors
25
Personnel
26
Administrative Hearings
27
State Bar
Citation
AD
AM
RP
With
Chgs
Corr
Eff.
Date
Temp.
Expires
10 NCAC 3K .0101 - .0104
/
/
04/01/95
3R .3001
/
/
04/01/95
.3020
/
•
04/01/95
.3030
/
/
04/01/95
.3032
/
/
04/01/95
.3040
/
/
04/01/95
.3050
/
/
04/01/95
3U .1001
/
/
07/01/95
11 NCAC 1 .0413
/
04/01/95
4 .0123 - .0124
/
/
04/01/95
.0432 - .0433
/
/
04/01/95
12 .1001
/
04/01/95
.1024
/
04/01/95
16 .0601 - .0602
/
/
04/01/95
♦
♦
167
NORTH CAROLINA REGISTER
April 17, 1995
10:2
LIST OF RULES CODIFIED
Citation
AD
AM
RP
With
Chgs
Corr
Eff.
Date
Temp.
Expires
11
NCAC 16
.0603 - .0606
/
04/01/95
.0607
/
/
04/01/95
12
NCAC 7D
.0113
•
04/01/95
13
NCAC 7F
.0101
•
04/01/95
.0301
•
04/01/95
15A
NCAC 2D
.0105
/
/
04/01/95
.0955 - .0957
/
/
05/01/95
.1201 - .1203
/
04/01/95
.1204
/
/
04/01/95
.1205
•
04/01/95
.1206
/
•
04/01/95
.1209
/
•
04/01/95
.1401 - .1412
/
/
04/01/95
.1413
/
04/01/95
.1414
/
•
04/01/95
.1415
/
04/01/95
.1501
•
•
04/01/95
.1502
•
04/01/95
.1503
/
/
04/01/95
.1504
/
04/01/95
.1601
/
/
04/01/95
.1602
/
04/01/95
.1603
/
/
04/01/95
2K
.0501 - .0503
•
•
04/01/95
7H
.0104
/
/
04/01/95
.0309
/
04/01/95
.0406
/
/
04/01/95
7J
.0403
•
/
04/01/95
.0404
/
04/01/95
12K
.0101
/
04/01/95
.0102 - .0106
/
•
04/01/95
.0107 - .0108
/
04/01/95
.0109 - .0111
/
•
04/01/95
70:2
NORTH CAROLINA REGISTER
April 17, 1995
168
LIST OF RULES CODIFIED
Citation
AD
AM
RP
With
Chgs
Corr
Eff.
Date
Temp.
Expires
15A NCAC 13A .0012
•
04/01/95
16A .0104
/
/
04/01/95
.0107
/
04/01/95
.0109
•
/
04/01/95
18A .3201 - .3202
/
/
04/01/95
.3203
/
04/01/95
.3204 - .3211
•
•
04/01/95
.3212
/
04/01/95
24A .0202
•
04/01/95
.0403
/
/
04/01/95
.0405
/
/
04/01/95
17 NCAC 7B .0123
/
04/01/95
.0707
/
04/01/95
.1101
/
04/01/95
.2401
/
04/01/95
.5436
•
04/01/95
.5437
/
04/01/95
19A NCAC 5B .0101
/
04/01/95
21 NCAC 14F .0007
/
•
04/01/95
14G .0003
•
04/01/95
141 .0103
/
04/01/95
14J .0205
•
/
04/01/95
18B .0901
/
/
04/01/95
25 NCAC IE .0902
/
/
04/01/95
26 NCAC 2A .0102
/
04/01/95
2B .0104
/
/
04/01/95
27 NCAC IB .0105
/
02/20/95
.0111 - .0112
/
02/20/95
.0125
/
02/20/95
ID .0203
/
.0206
/
02/20/95
.1604
/
2 10.2C0
•
02/20/95
769
A r 0/?77/ CAROLINA REGISTER
April 17, 1995
10:2
RRC OBJECTIONS
J. he Rules Review Commission (RRC) objected to the following rules in accordance with G.S. 150B-21.9(a). State
agencies are required to respond to RRC as provided in G.S. 150B-2 1.12(a).
ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
Coastal Management
15A NCAC 7H .0308 - Specific Use Standards for Ocean Hazard Areas
ISA NCAC 7M .0202 - Policy Statements
Environmental Health
ISA NCAC ISA .2801 - Definitions
Rule Approved as Written
ISA NCAC 18A .2810 - Specifications for Kitchens, Based on Number/Children
Agency Revised Rule
LICENSING BOARDS AND COMMISSIONS
Board of Cosmetic Art Examiners
21 NCAC 14F .0014 - Salon Renewal
21 NCAC 141 .0401 - App. for Licensure by Individuals Who Have Been Convicted of a Felony
21 NCAC 141 .0402 - Requests for Preapplication Review of Felony Convictions
Board of Examiners of Electrical Contractors
21 NCAC 18B .0901 - Applicants Convicted of Crimes
No Response from Agency
Board of Opticians
21 NCAC 40 .0314 - Apprenticeship and Internship Requirements; Registration
Agency Revised Rule
No Response from Agency
Agency Responded
No Response from Agency
PUBLIC EDUCATION
Elementary and Secondary Education
16 NCAC 6C .0207 - Prospective Teacher Scholarship Loans
REVENUE
Sales and Use Tax
17 NCAC 7B .1123 - Certain Sales to Commercial Livestock and Poultry Farmers
17 NCAC 7B .5445 - Commercial Swine, Livestock and Poultry Farmers' Cert. Form: E-599S
SECRETARY OF STATE
Notary Public Division
18 NCAC 7 .0301 - Approved Course of Study
No Response from Agency
Rule Returned to Agency
18 NCAC 7 .0302 - Instructors
No Response from Agency
Rule Returned to Agency
RRC Objection
03/16/95
RRC Objection
03/16/95
RRC Objection
01/19/95
Obj. Removed
02/16/95
RRC Objection
01/19/95
Obj. Removed
02/16/95
RRC Objection
03/16/95
RRC Objection
03/16/95
RRC Objection
03/16/95
RRC Objection
01/19/95
Obj. Contd
02/16/95
RRC Objection
11/17/94
Obj. Contd
11/17/94
Obj. Contd
12/15/94
Obj. Contd
01/19/95
Obj. Contd
02/16/95
RRC Objection 02/16/95
RRC Objection
RRC Objection
03/16/95
03/16/95
RRC
Objection
12/15/94
Obj.
Contd
01/19/95
Obj.
Contd
02/16/95
RRC
Objection
12/15/94
Obj.
Contd
01/19/95
Obj.
Contd
02/16/95
10:2
NORTH CAROLINA REGISTER
April 17, 1995
170
CONTESTED CASE DECISIONS
1 his Section contains the full text of some of the more significant Administrative Law Judge decisions along with an index
to all recent contested cases decisions which are filed under North Carolina's Administrative Procedure Act. Copies of
the decisions listed in the index and not published are available upon request for a minimal charge by contacting the
Office of Administrative Hearings, (919) 733-2698.
«
AGENCY
CASE
NUMBER
ALJ
DATE OF
DECISION
PUBLISHED DECISION
REGISTER CITATION
ADMINISTRATION
Division of Purchase and Contract
Senter-Sanders Tractor Corp. v. Admin., Div of Purchase & Contract
ALCOHOLIC BEVERAGE CONTROL COMMISSION
Norman D. Forbes v. Alcoholic Beverage Control Commission
Albert Stanley Tomanec v. Alcoholic Beverage Control Commission
CRIME CONTROL AND PUBLIC SAFETY
Crime Victims Compensation Commission
John Pavlikianklis v. Victims Compensation Commission
Wayne L. Utley v. Crime Victims Compensation Commission
Thomasine Inman v. Crime Victims Compensation Commission
Irmgard Gordo* v. Crime Victims Compensation Commission
Ellen Sherwin v. Crime Vic Comp James Byrum Emp/ Baptist Hosp
ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
Setzer Bros. Inc. v. Environment, Health, and Natural Resources
John W. VanHoy, Jr. & Adjacent Land Owners v. EHNR
and
Shugart Enterprises, Inc.
94 DOA 0803 Nesnow
94 ABC 0787
94 ABC 1168
Gray
Bee ton
94 CPS 0237
Morrison
94 CPS 1180
Bee ton
94 CPS 1731
Nesnow
94 CPS 1782
Gray
95 CPS 0012
West
94 EHR 1676
95 EHR 0016
Nesnow
Phipps
95 EHR 0140 Phipps
Coastal Resources
Howard C. Slack v. Coastal Resources Comm, EHNR
Davidson County Health Department
John Dee Clodfelter V, Davidson County Health Dept.; EHNR 94 EHR 1037 Chess
Hyde County Health Department
Fritzner Henry v. Hyde County Health Department 94 EHR 0924 Gray
Macon County Health Department
Four Residents on Genva Circle v. Macon County Health Department 94 EHR 1202 Nesnow
Maternal and Child Health
Philip Haakins v. EHNR, Div. of Maternal & Child Health 94 EHR 1777 Chess
EQUAL EMPLOYMENT OPPORTUNITY
Marsha Dianne McKoy v. DHR, Div. of MH/DD/SAS, Caswell Center 94 EEO 0379 Chess
HUMAN RESOURCES
Helen J. Walls, D/B/A Walls Young World v. Human Resources 94 DHR 1362 Becton
03/06/95
03/17/95
03/07/95
03/21/95
03/07/95
03/09/95
03/09/95
03/22/95
03/09/95
03/17/95
03/22/95
03/13/95
03/09/95
03/27/95
03/09/95
02/21/95
03/20/95
10:2 NCR 176
i
10:2 NCR 186
♦
171
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CONTESTED CASE DECISIONS
AGENCY
CASE
NUMBER
ALJ
DATE OF
DECISION
PUBLISHED DECISION
REGISTER CITATION
Division of Child Development
Iola Malloy v. DHR, Division of Child Development
Esther Elder v. DHR, Division of Child Development
94 DHR 0849
94 DHR 1771
Mann
Reilly
03/03/95
03/17/95
Facility Services
William H. Cooke v. DHR, Division of Facility Services
Mildred Reece, Calvin Reece v. DHR, Division of Facility Svcs,
Domiciliary & Group Care Section
94 DHR 0565
94 DHR 1783
Certificate of Need Section
Retirement Villages, Inc. (Lessor), and Liberty Healthcare Ltd. 94 DHR 0403
Partnership (Lessee) D/B/A Countryside Villa of Duplin v. DHR,
Division of Facility Services, Certificate of Need Section
and
Beaver Properties/Wallace, Inc., and Brian Center Health & Retirement/
Wallace, Inc.
Gray
Gray
Chess
03/16/95
03/16/95
12/14/94
Division of Social Services
Child Support Enforcement Section
Daniel J. Carter v. Department of Human Resources
Shawn Dominic Caldwell v. Department of Human Resources
William Zonta Thompson v. Department of Human Resources
Jackie E. Hackney v. Department of Human Resources
Elbert Quick v. Department of Human Resources
Clement McMillan v. Department of Human Resources
James R. Gray v. Department of Human Resources
Lacy Green, Jr. v. Department of Human Resources
Edwin A. Clarke v. Department of Human Resources
Lloyd Lane Speake v. Department of Human Resources
Henry C. Banks v. Department of Human Resources
Lucille B. Dutter v. Department of Human Resources
Gary Jay Stocks v. Department of Human Resources
Paul E. Strawcutter v. Department of Human Resources
Cary G. Dannelly v. Department of Human Resources
Robert G. Baker v. Department of Human Resources
Timothy Brian Eller v. Department of Human Resources
Morgan Pate, Jr. v. Department of Human Resources
Robert E. Dudley, Sr. v. Department of Human Resources
Julian Lattimore v. Department of Human Resources
James McFadden v. Department of Human Resources
Raymond B. Clontz Jr. v. Department of Human Resources
Ruby Fewell Henry v. Department of Human Resources
Richard Dill v. Department of Human Resources
Ted C. Jenkins v. Department of Human Resources
Anthony J. Gibbons v. Department of Human Resources
Donald L. Costello Sr. v. Department of Human Resources
Kelvin L. Lankford v. Department of Human Resources
Jeffrey Thomas Chambers v. Department of Human Resources
Robert J. Holden v. Department of Human Resources
Michael L. Wright v. Department of Human Resources
Terry S. Gurganus v. Department of Human Resources
John Napoleon Window Cross Pullium v. Dept of Human Resources
Michael J. Montroy v. Department of Human Resources
Dennis L. Moore v. Department of Human Resources
James Edward Knox, Jr. v. Department of Human Resources
David House v. Department of Human Resources
Aqustin S. Sanchez v. Department of Human Resources
Ricky Ratliff v. Department of Human Resources
Willie McNeil Jr. v. Department of Human Resources
Ray Douglas Brickhouse v. Department of Human Resources
Tyron G. Moore v. Department of Human Resources
Paul A. Card v. Department of Human Resources
91 CSE 1103
Morrison
03/03/95
92 CSE 1449
Reilly
03/29/95
92 CSE 1559
Reilly
03/29/95
93 CSE 1088
Chess
03/20/95
93 CSE 1169
Chess
03/08/95
93 CSE 1208
Chess
03/08/95
93 CSE 1268
Chess
03/08/95
93 CSE 1295
Chess
03/08/95
93 CSE 1319
Chess
03/08/95
93 CSE 1451
Chess
03/22/95
93 CSE 1556
Chess
03/22/95
93 CSE 1558
Chess
03/13/95
93 CSE 1652
Chess
03/21/95
93 CSE 1713
Mann
03/13/95
94 CSE 1033
Nesnow
03/24/95
94 CSE 1094
Chess
03/06/95
94 CSE 1119
Reilly
03/29/95
94 CSE 1127
Mann
03/20/95
94 CSE 1 128
Mann
03/31/95
94 CSE 1131
Reilly
03/13/95
94 CSE 1132
West
03/14/95
94 CSE 1149
Nesnow
03/03/95
94 CSE 1 157
Nesnow
03/16/95
94 CSE 1195
Mann
03/29/95
94 CSE 1218
Gray
03/15/95
94 CSE 1219
Gray
03/15/95
94 CSE 1228
West
03/17/95
94 CSE 1229
West
03/17/95
94 CSE 1231
Nesnow
03/03/95
94 CSE 1232
Nesnow
03/15/95
94 CSE 1237
Gray
03/15/95
94 CSE 1239
Gray
03/02/95
94 CSE 1241
Gray
03/15/95
94 CSE 1244
Morrison
03/13/95
94 CSE 1249
Morrison
03/02/95
94 CSE 1254
Reilly
03/13/95
94 CSE 1256
Reilly
03/15/95
94 CSE 1259
West
03/06/95
94 CSE 1261
West
03/17/95
94 CSE 1262
West
03/17/95
94 CSE 1263
West
03/17/95
94 CSE 1264
West
03/17/95
94 CSE 1266
Nesnow
03/13/95
10:2
NORTH CAROLINA REGISTER
April 17, 1995
172
CONTESTED CASE DECISIONS
AGENCY
Darrin Yancey v. Department of Human Resources
Douglas L. Lucas v. Department of Human Resources
Gregory D. Simpson v. Department of Human Resources
Michael Lynn Avery v. Department of Human Resources
Elvis M. Graham v. Department of Human Resources
Shawn Fonville v. Department of Human Resources
Shannon Vanderaa v. Department of Human Resources
Anthony Murray v. Department of Human Resources
Tommy L. Burchfield v. Department of Human Resources
Gregory A. Rodrigues v. Department of Human Resources
Larry R. Bales v. Department of Human Resources
Karl Philip Jureen v. Department of Human Resources
Otis Lewis Jr. v. Department of Human Resources
Robert F. Catoe Jr. v. Department of Human Resources
William Anthony Winchester v. Department of Human Resources
Aaron L. Clark v. Department of Human Resources
Vincent R. Valles Sr. v. Department of Human Resources
Gary W. Gibson v. Department of Human Resources
Mark A. West v. Department of Human Resources
John E. Bolas Jr. v. Department of Human Resources
Gary C. Wiggins v. Department of Human Resources
Rhonnie J. Williams v. Department of Human Resources
Danny Ray Hensley v. Department of Human Resources
Ivy M. Harvell v. Department of Human Resources
Terry L. McMillon v. Department of Human Resources
Garry G. Hickman v. Department of Human Resources
Willie Herring v. Department of Human Resources
Joe C. Dean v. Department of Human Resources
Jimmic E. Barnes v. Department of Human Resources
Cecilia Carmosino v. Department of Human Resources
Marvin F. Walker v. Department of Human Resources
Richard J. Almeida v. Department of Human Resources
Michael R. French v. Department of Human Resources
John A. Jackson v. Department of Human Resources
Michael R. Roberts v. Department of Human Resources
Cleothis B. Smith v. Department of Human Resources
Leroy Johnson Jr. v. Department of Human Resources
James Patterson v. Department of Human Resources
Thomas Colon v. Department of Human Resources
Walter Swirniak Jr. v. Department of Human Resources
Marion Rodriguez v. Department of Human Resources
Jerry L. White Sr. v. Department of Human Resources
Dennis James Grimes v. Department of Human Resources
Scott John Tozzi v. Department of Human Resources
Roger A. Eaton v. Department of Human Resources
Willie J. Flowers Jr. v. Department of Human Resources
Jeffrey James Spence v. Department of Human Resources
Byron C. Alston v. Department of Human Resources
Oliver Lee Wolfe Sr. v. Department of Human Resources
James Tracy Strickland v. Department of Human Resources
Michael K. Reese v. Department of Human Resources
Richard G. Medford, Jr. v. Department of Human Resources
Theresa Strader v. Department of Human Resources
James F. Williams v. Department of Human Resources
Marion A. Ward v. Department of Human Resources
Robert Lee Wall v. Department of Human Resources
James M. Breaden Jr. v. Department of Human Resources
Peter G. Coley v. Department of Human Resources
Benjamin Nuriddin v. Department of Human Resources
Robert L. Carter v. Department of Human Resources
Danny Columbus Baker v. Department of Human Resources
Duke William Dupre' v. Department of Human Resources
Audrey Jennings v. Department of Human Resources
Michael A. Camp v. Department of Human Resources
Martin J. Miller v. Department of Human Resources
Willie Cherry, Jr. v. Department of Human Resources
William V. Glennon v. Department of Human Resources
Alaster Williams v. Department of Human Resources
CASE
DATE OF
NUMBER
ALJ
DECISION
94 CSE 1269
Nesnow
03/15/95
94 CSE 1270
Nesnow
03/15/95
94 CSE
1272
Becton
03/15/95
94 CSE
1274
Becton
03/15/95
94 CSE
1275
Becton
03/15/95
94 CSE
1277
Becton
03/06/95
94 CSE
1286
Mann
03/21/95
94 CSE
1287
Mann
03/21/95
94 CSE
1289
Mann
03/21/95
94 CSE
1300
Mann
03/21/95
94 CSE
1302
Gray
03/02/95
94 CSE
1303
Gray
03/15/95
94 CSE
1314
Mann
03/21/95
94 CSE
1329
Morrison
03/15/95
94 CSE
1331
Reilly
03/15/95
94 CSE
1332
Reilly
03/15/95
94 CSE
1333
West
03/17/95
94 CSE
1334
West
03/06/95
94 CSE 1335
West
03/17/95
94 CSE
1336
Nesnow
03/15/95
94 CSE 1338
Nesnow
03/15/95
94 CSE 1339
Becton
03/15/95
94 CSE 1340
Becton
03/15/95
94 CSE
1345
Mann
03/21/95
94 CSE
1346
Mann
03/21/95
94 CSE
1348
Gny
03/15/95
94 CSE
1350
Morrison
03/02/95
94 CSE 1351
Morrison
03/15/95
94 CSE 1352
Reilly
03/03/95
94 CSE
1354
West
03/17/95
94 CSE
1355
West
03/17/95
94 CSE
1357
Nesnow
03/15/95
94 CSE
1359
Becton
03/15/95
94 CSE
1370
Mann
03/07/95
94 CSE
1371
Mann
03/21/95
94 CSE 1373
Gray
03/15/95
94 CSE
1377
Mann
03/31/95
94 CSE
1378
Morrison
03/15/95
94 CSE
1379
Reilly
03/15/95
94 CSE
1382
West
03/17/95
94 CSE
1385
Nesnow
03/03/95
94 CSE
1387
Nesnow
03/15/95
94 CSE
1388
Becton
03/15/95
94 CSE
1389
Becton
03/15/95
94 CSE
1392
Gray
03/09/95
94 CSE
1393
Morrison
03/15/95
94 CSE
1394
Reilly
03/15/95
94 CSE
1396
Nesnow
03/03/95
94 CSE
1397
Mann
03/31/95
94 CSE
1398
Mann
03/31/95
94 CSE
1412
Gray
03/31/95
94 CSE
1415
Morrison
03/02/95
94 CSE
1416
MorriBOn
03/21/95
94 CSE
1417
Morrison
03/21/95
94 CSE
1421
Reilly
03/03/95
94 CSE 1425
West
03/31/95
94 CSE
1426
West
03/31/95
94 CSE
1427
West
03/31/95
94 CSE
1429
West
03/31/95
94 CSE
1430
Nesnow
03/24/95
94 CSE
1431
Nesnow
03/24/95
94 CSE
1432
Nesnow
03/24/95
94 CSE
1433
Nesnow
03/24/95
94 CSE
1435
Becton
03/06/95
94 CSE
1436
Becton
03/06/95
94 CSE
1439
Chess
03/03/95
94 CSE
1444
Mann
03/07/95
94 CSE
1445
Gray
03/02/95
PUBLISHED DECISION
REGISTER CITATION
173
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CONTESTED CASE DECISIONS
AGENCY
Henry L. Gibbs v. Department of Human Resources
Beau L. Miller v. Department of Human Resources
Elizabeth F. West v. Department of Human Resources
Lori Davis Humphrey v. Department of Human Resources
Cyrus R. Luallen v. Department of Human Resources
Harold Dean Horn v. Department of Human Resources
James B. Miller v. Department of Human Resources
Glenn Allison v. Department of Human Resources
Louis R. Salamone v. Department of Human Resources
Randy Norris Willis v. Department of Human Resources
Michael E. Bellamy v. Department of Human Resources
Eddie James Johnson v. Department of Human Resources
Co ley C. Matthews v. Department of Human Resources
Peter Ian Oliveira v. Department of Human Resources
Ronald E. Lewis v. Department of Human Resources
Carlos L. Robinson v. Department of Human Resources
Eddie O. Toro v. Department of Human Resources
Bruce Kelly Jacobs v. Department of Human Resources
Tony Collins v. Department of Human Resources
Marvin B. Harris v. Department of Human Resources
Dennis Ray Alexander v. Department of Human Resources
Joseph R. & Linda M. Grooms v. Department of Human Resources
Robert M. Martin v. Department of Human Resources
Louis Cragg III v. Department of Human Resources
Ellen Downing v. Department of Human Resources
Charles R. Hauley v. Department of Human Resources
Michael L. Schadlcr v. Department of Human Resources
Terrencc R. McLaughlin v. Department of Human Resources
Joel P. Roth v. Department of Human Resources
At ward T. Warren v. Department of Human Resources
Roger T. Benoy v. Department of Human Resources
Kenneth J. Balfour v. Department of Human Resources
Dennis W. Nolan v. Department of Human Resources
Randolph J. Nunn v. Department of Human Resources
David Lester Gordon v. Department of Human Resources
Jimmy R. Jackson v. Department of Human Resources
Mark A. Jones v. Department of Human Resources
Ondino Damota Freitas v. Department of Human Resources
Nelson Bennett v. Department of Human Resources
Robert Larry Martin v. Department of Human Resources
Joseph O. Evans v. Department of Human Resources
Donald E. Kirby v. Department of Human Resources
Paul R. Ross v. Department of Human Resources
CASE
DATE OF
PUBLISHED DECISION
NUMBER
AU
DECISION
REGISTER CITATION
94 CSE 1446
Morrison
03/21/95
94 CSE 1452
West
03/07/95
94 CSE 1455
Nesnow
03/07/95
94 CSE 1459
Becton
03/06/95
94 CSE 1470
Mann
03/31/95
94 CSE 1471
Mann
03/07/95
94 CSE 1472
Mann
03/07/95
94 CSE 1473
Gray
03/02/95
94 CSE 1474
Gray
03/09/95
94 CSE 1476
Morrison
03/21/95
94 CSE 1477
Morrison
03/02/95
94 CSE 1478
Morrison
03/02/95
94 CSE 1479
Morrison
03/21/95
94 CSE 1489
Becton
03/07/95
94 CSE 1491
Becton
03/07/95
94 CSE 1499
Mann
03/31/95
94 CSE 1500
Mann
03/31/95
94 CSE 1508
Gray
03/31/95
94 CSE 1511
Gray
03/02/95
94 CSE 1533
Morrison
03/02/95
94 CSE 1538
Reilly
03/03/95
94 CSE 1539
Reilly
03/07/95
94 CSE 1541
Reilly
03/07/95
94 CSE 1543
West
03/06/95
94 CSE 1553
Nesnow
03/30/95
94 CSE 1554
Becton
03/07/95
94 CSE 1555
Becton
03/07/95
94 CSE 1569
Chess
03/07/95
94 CSE 1572
West
03/14/95
94 CSE 1573
West
03/31/95
94 CSE 1579
Reilly
03/03/95
94 CSE 1584
Morrison
03/07/95
94 CSE 1590
Gray
03/31/95
94 CSE 1608
Mann
03/21/95
94 CSE 1609
Mann
03/13/95
94 CSE 1648
Gray
03/09/95
94 CSE 1649
Morrison
03/07/95
94 CSE 1650
Reilly
03/07/95
94 CSE 1656
Gray
03/02/95
94 CSE 1750
Chess
03/21/95
94 CSE 1766
Chess
03/21/95
94 CSE 1767
Reilly
03/03/95
94 CSE 1778
West
03/06/95
JUSTICE
Alarm Systems Licensing Board
Patrick P. Sassman v. Alarm Systems Licensing Board
Private Protective Services Board
94 DOJ 1825
Reilly
03/09/95
Lewis Austin Saintsing v. Private Protective Services Board
Marcus T. Williams v. Private Protective Services Board
Melvin Ray Cooper v. Private Protective Services Board
Donnell E. Morrow, Jr. v. Private Protective Services Board
94 DOJ 1000
Chess
03/03/95
94 DOJ 1064
Chess
02/24/95
94 DOJ 1635
Reilly
03/09/95
94 DOJ 1823
Reilly
03/09/95
LABOR
Wage and Hour Division
R.J. Scott, Pres. Pirate Enterprises, Inc. v. Labor, Wage & Hour Division 94 DOL 1524
PUBLIC INSTRUCTION
West
03/23/95
Glenn II, on behalf of Glenn II, and Glenn II, Individually v. Charlotte- 93 EDC 0549 Chess
Mecklenburg County Schools
William Hewett v. State Board of Education 94 EDC 0533 Gray
03/16/95
03/31/95 10:2 NCR 179
10:2
NORTH CAROLINA REGISTER
April 17, 1995
174
CONTESTED CASE DECISIONS
AGENCY
Bobby G. Little v. Department of Public Instruction
STATE PERSONNEL
Caswell County Health Department
Julie R. Johnson v. Caswell County Health Department
Department of Correction
Nancy Gilchrist v. Department of Correction
Thomas Wayne Smathcrs v. Department of Correction
Ruth Kearney v. Department of Correction
Office of ike District Attorney
Shannon Caudill v. Office of the District Attorney for Judicial
District 17-B, and Administrative Office of the Courts
Forsyth Stokes Mental Health Center
Michael Howell v. Forsyth Stokes Mental Health Center
Department of Human Resources
Rebecca Johnson v. Human Resources, Special Care Center
Cherry Hospital
William H. Cooke v. DHR, Cherry Hospital
Iredell County Department of Social Services
Vemon E. Crosse v. Iredell County Department of Social Services
Bonnie N. Bellamy v. Iredell County Department of Social Services
CASE
NUMBER
95 EDC 0168
94 OSP 0865
95 OSP 0188
94 OSP 0499
95 OSP 0138
93 OSP 1547
94 OSP 0282
94 OSP 0739
ALJ
Phippe
Reilly
Nesnow
Chess
West
Gray
Bee ton
Chess
Lee-Harnett Area Mental Health, Developmental Disabilities, and Substance Abuse Authority
Julie Dyer v. Lee-Harnett Area MH/DD/SA Authority
North Carolina State University
Billy Ray Kelly v. NCSU Physical Plant
Department of Transportation
Michael E. Kornegay v. Department of Transportation
UNC Hospitals
David Patrick Malone v. Univ. of NC Hospital at Chapel Hill
94 OSP 0750
95 OSP 0130
93 OSP 1700
94 OSP 0771
Gray
West
Gray
Becton
DATE OF
DECISION
03/20/95
PUBLISHED DECISION
REGISTER CITATION
03/15/95
94 OSP 0121
West
03/09/95
94 OSP 0590
West
03/23/95
94 OSP 1807
Becton
03/13/95
03/20/95
03/24/95
03/31/95
03/16/95
03/09/95
03/01/95
03/20/95
03/22/95
03/24/95
03/14/95
♦
10:01 NCR 48
i
♦
175
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CONTESTED CASE DECISIONS
STATE OF NORTH CAROLINA
COUNTY OF CUMBERLAND
IN THE OFFICE OF
ADMINISTRATIVE HEARINGS
94 CPS 0237
JOHN PAVLHOAMDIS
Petitioner,
N.C. VICTIMS COMPENSATION
COMMISSION
Respondent.
RECOMMENDED DECISION
Petitioner filed a timely Petition for a Contested Case Hearing with the Office of Administrative Hearings on
February 22, 1994.
On March 15, 1995, this contested case came on for hearing by telephone conference with Fred G. Morrison Jr.,
Senior Administrative Law Judge presiding.
APPEARANCES
For Petitioner: James H. Cooke, Jr.
Parish, Cooke and Russ
P.O. Drawer 1824
Fayetteville, NC 28302
For Respondent: Robert T. Hargett
Assistant Attorney General
N.C. Department of Justice
P.O. Box 629
Raleigh, NC 27602-0629
STATUTES AT ISSUE
N.C. Gen. Stat. §§15B-4(a) & 15B-1 1(a)(3)
ISSUE
Did the N.C. Crime Victims Compensation Commission properly deny Petitioner's claim?
FINDINGS OF FACT
1. Alexandra Pavlikianidis, age 13, daughter of Petitioner, rode her bike to the Honeycutt Recreation area in
Fayetteville on Sunday, August 30, 1992.
2. When Alexandra arrived at the park, she stopped to get a drink by the public bathroom. When she stopped, she
noticed three girls approximately 10 to 13 years of age playing near the area.
3. When Alexandra was trying to go up some playground equipment stairs after resting, the three girls came running
down the stairs towards her. During this incident, Alexandra was pushed, shoved, or bumped backwards down the stairs.
She fell over the handrail and down to the base of the steps. The three girls laughed and ran off after Alexandra had fallen.
4. There were three women at the scene with their children and two of them rushed over to Alexandra and asked if
she was okay. She told them that her ankle and foot were hurt. One of the women offered her a ride home.
5. The other woman went to see where the three girls had gone. The woman yelled for the girls to come back and
10:2
NORTH CAROLINA REGISTER
April 17, 1995
176
CONTESTED CASE DECISIONS
brought the oldest girl back to where Alexandra was.
6. When Alexandra returned home, her mother took her to the Doctors Urgent Care to have them look at her injuries.
The doctor put a cast on Alexandra's leg and told her that she might need surgery. He referred her to another doctor.
7. On August 31, 1992, Petitioner and Alexandra spoke with someone at the Parks and Recreation Department to report
the incident. They were told to make a report with the police.
8. Pete Pavlikianidis, Alexandra's uncle, called the police on August 31, 1992, to make a report. They took
Alexandra's statement over the telephone and then spoke to her father. They asked her if she had reported the incident to
the Parks and Recreation Department and she told them that she had.
9. On August 31, 1992, Alexandra spoke to Investigator Tew of the Fayetteville Police Department who took her
statement and asked her about the report made to the Parks and Recreation Department. Investigator Tew also asked
Alexandra about the police report she had previously made. Alexandra also spoke to George McCarthy from the Risk
Management Division of the Parks and Recreation Department.
10. On August 31, 1992, Alexandra went to see Dr. George Dimitri who told her that she would need surgery on her
foot. He told her that she had broken four toes and two connective bones in her foot.
11. On September 2, 1992, Alexandra had surgery on her foot and was out of school for more than two months after
the surgery.
12. Alexandra has been required to have continuous follow-up care, including physical therapy, which has caused her
to miss school.
13. Petitioner's father filed a claim for compensation with Respondent which was denied.
14. Pushing and shoving by children playing are facts of life.
Based upon the foregoing Findings of Fact, the undersigned makes the following:
CONCLUSIONS OF LAW
1. The Office of Administrative Hearings has jurisdiction over the parties and subject matter of this contested case
pursuant to G.S. 150B and 15B.
2. Subject to the limitations in G.S. 15B-22,
compensation for criminally injurious conduct shall be awarded to a claimant if substantial evidence
established that the requirements for an award have been met. . . .
N.C. Gen. Stat. §15B-4(a) (1994) (emphasis added).
3. The statute defines "criminally injurious conduct" as:
(C)onduct which by its nature poses a substantial threat of personal injury or death, and is punishable by
fine or imprisonment or death, . . .
N.C. Gen. Stat. §15B-2(5) (1994) (emphasis added).
4. The evidence is inconclusive as to whether or not Alexandra was injured by criminally injurious conduct, the proof
of which is a necessary element for the award of compensation. Pushing and shoving by children on a public playground
does not alone constitute criminal conduct within the purview of G.S. 15B.
Based upon the foregoing Findings of Fact and Conclusions of Law, the undersigned makes the following:
177 NORTH CAROLINA REGISTER April 17, 1995 10:2
CONTESTED CASE DECISIONS
RECOMMENDED DECISION
It is recommended that Petitioner's claim for compensation be denied.
ORDER
It is hereby ordered that the agency serve a copy of the final decision on the Office of Administrative Hearings, P.O.
Drawer 27447, Raleigh, N.C. 27611-7447, in accordance with North Carolina General Statute 150B-36(b).
NOTICE
The agency making the final decision in this contested case is required to give each party an opportunity to file
exceptions to this recommended decision and to present written arguments to those in the agency who will make the final
decision. G.S. 150B-36(a).
The agency is required by G.S. 150B-36(b) to serve a copy of the final decision on all parties and to furnish a copy
to the parties' attorney of record and to the Office of Administrative Hearings.
The agency that will make the final decision in this contested case is the North Carolina Crime Victims
Compensation Commission.
This the 21st day of March, 1995.
Fred G. Morrison Jr.
Senior Administrative Law Judge
10:2 NORTH CAROLINA REGISTER April 17, 1995 178
CONTESTED CASE DECISIONS
STATE OF NORTH CAROLINA
COUNTY OF BRUNSWICK
IN THE OFFICE OF
ADMINISTRATIVE HEARINGS
94 EDC 0533
♦
WILLIAM HEWETT,
Petitioner,
THE NORTH CAROLINA
STATE BOARD OF EDUCATION,
Respondent.
RECOMMENDED DECISION
This contested case was heard before Beecher R. Gray, administrative law judge, on October 17 and 18, 1994 in
Southport, North Carolina. Following receipt of transcripts of the proceeding, Respondent and Petitioner filed proposed
decisions and written arguments on February 27, 1995 and March 6, 1995, respectively.
APPEARANCES
Petitioner: Don W. Viets, Esq.
Respondent: Barbara A. Shaw, Assistant Attorney
General, North Carolina Department of Justice.
EXHIBITS
Exhibits 1-5 were admitted into evidence
Offered no exhibits into evidence
EXPERT WITNESSES
Thomas Lewis was tendered and accepted as an expert in education.
Carlton Prince was tendered and accepted as an expert in education.
Coleman Barbour was tendered and accepted as an expert in education and as a middle school and high
Respondent:
Petitioner:
Petitioner:
1.
2.
i
3.
school principal.
4. Joseph Miller was tendered and accepted as an expert in teaching Health and Physical Education at the high
school level.
5. Timothy Fitzgerald was tendered and accepted as an expert in teaching Health, Physical Education, History,
and Vocational Education.
Respondent:
Respondent did not offer any expert testimony.
ISSUES
1. Whether Respondent has substantial evidence, sufficient to justify permanent revocation of Petitioner's
teaching certificate, that Petitioner has been convicted of a crime, as an adult, and that there is a reasonable and adverse
♦
179
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CONTESTED CASE DECISIONS
relationship between the underlying crime and his continuing ability to perform any of his professional functions effectively.
2. Whether Respondent has substantial evidence, sufficient to justify permanent revocation of Petitioner's
teaching certificate, that Petitioner has engaged in other illegal, unethical, or lascivious conduct and that there is a reasonable
and adverse relationship between the underlying conduct and his continuing ability to perform any of his professional
functions effectively.
FINDINGS OF FACT
1 . The parties received notice of hearing more than 15 days prior to the hearing and each stipulated on the record that
notice was proper in all respects.
2. Petitioner currently holds a teaching certificate issued by the State Board of Education.
3. Petitioner resides in Brunswick County and did so at the time of the events giving rise to this contested case appeal.
4. Petitioner was employed by South Brunswick High School (SBHS) in June, 1990 to serve as a teacher, head football
coach, and athletic director. Petitioner taught health and physical education and remedial math to both males and females
at SBHS.
5. Prior to his employment with SBHS, Petitioner worked for a number of years as a teacher and coach in other high
school systems in both North and South Carolina.
6. On or about November 17, 1993, Petitioner was suspended from his position with SBHS because of allegations
arising from November 16, 1993 off-campus encounters between Petitioner and two current female students at SBHS in
which it was alleged that Petitioner was intoxicated and had touched the breasts of the two students without consent.
Petitioner did not return to his position and eventually resigned in February, 1994. The allegations against Petitioner were
investigated by the Brunswick County School Superintendent. The investigation and allegations were covered by the press.
7. The parties stipulated, and it is found as fact, that Petitioner received a January 27, 1994 document captioned
FINDING OF REASONABLE CAUSE AND STATEMENT OF CHARGES. The reasonable cause section of this document
provides, in pertinent part:
Bob Etheridge, State Superintendent of Public Instruction, having received notice from the Brunswick
County Schools, finds that:
[o]n the evening of November 16, 1993, Mr. Hewett appeared intoxicated at two restaurants where female students
were working, and deliberately touched two current female students on their breasts, following which the students
filed criminal charges against Mr. Hewett (sic).
3. While Mr. Hewett denies all allegations except that of being intoxicated on the evening of November 16,
1993, the superintendent has found there is substantial reason to believe that Mr. Hewitt (sic) has violated
16 NCAC 6C .0312(b)(8).
4. The State Board of Education has adopted a rule, codified as 16 NCAC 6C .0312, that governs the
suspension or revocation of certificates. That rule provides, in part, that the Board may revoke a certificate
for any illegal, unethical or lascivious conduct by a person if there is a reasonable and adverse relationship
between the underlying conduct and the continuing ability of the person to perform any of his/her
professional functions in an effective manner.
8. In the Statement of Charges section of this January 27, 1994 document, the State Superintendent states in pertinent
part:
On the basis of this determination of reasonable cause, the State Superintendent files written charges against Mr.
10:2 NORTH CAROLINA REGISTER April 17, 1995 180
CONTESTED CASE DECISIONS
Hewlett (sic) as follows:
1 . The Brunswick County school superintendent has reported that he has substantial reason to believe
that:
On the evening of November 16, 1993, Mr. Hewett appeared intoxicated at two restaurants where female students
were working, and deliberately touched two current female students on their breasts, following which the students
filed criminal charges against Mr. Hewitt (sic).
2. These actions constitute grounds for the revocation cf his certificate pursuant to 16 NCAC 6C .0312(a)(8)
and indicate that the certificate should in fact be revoked.
9. Respondent's rule cited by Superintendent Etheridge as authority for revocation of Petitioner's certificate provides,
in pertinent part:
(a) The SBE may deny an application for certification or may suspend or revoke a certificate issued by the
department only for the following reasons:
(1) fraud, material misrepresentation or concealment in the application for certification;
(2) changes in or corrections of the certificate documentation which makes the individual
ineligible to hold a certificate;
(3) conviction or entry of a plea of no contest, as an adult, of a crime if there is a reasonable and
adverse relationship between the underlying crime and the continuing ability of the person to
perform any of his/her professional functions in an effective manner;
(4) final dismissal of a person by a local board pursuant to G.S. 115C-325(e)(l)b., if there is a
reasonable and adverse relationship between the underlying misconduct and the continuing ability
of the person to perform any of his/her professional functions effectively;
(5) final dismissal of a person by a LEA under G.S. 115C-325(e)(l)e;
(6) resignation from employment with a LEA without thirty work days' notice, except with the prior
consent of the local superintendent;
(7) revocation of a certificate by another state; and
(8) any other illegal, unethical or lascivious conduct by a person, if there is a reasonable and adverse
relationship between the under-lying conduct and the continuing ability of the person to perform
any of his/her professional functions in an effective manner.
(9) Failure to report revocable conduct as required under paragraph (b) of this Rule. N.C. Admin.
Code, tit. 16, r. 6C.03 12(a) (November, 1994).
10. Respondent contends in this certificate action against Petitioner that it has grounds to revoke his certificate under
both .0312(a)(3) and .0312(a)(8).
11. SBHS senior Tina Mount filed a criminal charge against Petitioner on November 27, 1993 for assault on a female
over 18 years of age by grabbing her breast . This charge was tried before a District Court Judge in Brunswick County on
June 3, 1994. Petitioner entered a plea of not guilty. The District Court Judge found Petitioner guilty of assault on a female
over the age of 18 by grabbing her breast in violation of G.S. 14-33(b)(2) as charged. The District Court ordered a prayer
for judgment continued upon payment of court costs. This is the only charge asserted by Respondent as grounds for
revocation of Petitioner's Certificate under either its Conviction Rule, .0312(a)(3) or its Conduct Rule, .0312(a)(8).
12. Tina Mount did not appear and testify in this contested case hearing.
181 NORTH CAROLINA REGISTER April 17, 1995 10:2
CONTESTED CASE DECISIONS
13. Marsha Cochran, guidance counselor at SBHS since 1985 and at the time of the events in this case, observed that
Tina Mount, who worked in her office as a student mentor, was happy and outgoing prior to November 16, 1993 but
became nervous and more withdrawn after that date.
14. Respondent offered no direct evidence of the conduct of Petitioner on the evening of November 16, 1993.
Respondent asserts that it can imply the underlying conduct by proving that Petitioner received a guilty verdict, with a prayer
for judgment continued, in the District Court criminal trial.
15. Petitioner went to a bar/restaurant known as the Shamrock in Southport on the evening of November 16, 1993.
When he entered the restaurant, Tina Mount was working as a waitress and spoke to him as he entered. Petitioner ordered
a beer and later ordered a meal. Petitioner had consumed one or more drinks during an earlier visit to the Shamrock that
evening. Tina Mount sat at his table and talked with Petitioner. He offered to buy a drink for her. She refused because
she was working. He gave her five dollars with which to buy herself a drink after she finished work. She told him that
she was a student at SBHS. While she was standing and he was seated, he gave her a hug around the waist. As they walked
toward the door on his way out, he reached for her arm and touched her breast during the process. Petitioner's
uncontroverted testimony is that he was reaching for her arm to say thanks and accidentally touched her breast, for which
he apologized before leaving.
16. Ralph Ward has been in education for thirty-six years, serving as personnel director of the Brunswick Schools for
the last seven. He gave a lay opinion under G.S. 8C-1, Rule 701, regarding Petitioner's ability to continue to perform his
professional functions after being found guilty of assault on a female. Mr. Ward's opinion as personnel director of SBHS
was that some students would have concerns about their safety and parents would have concerns about their students' safety
under Petitioner's control. He also believes that Petitioner's return to teaching would raise a concern that another similar
incident could occur and that morale in the school would be affected negatively.
17. Thomas Lewis has been in education for thirty-eight years, serving as principal for twenty-eight of those years.
He was tendered and accepted as an expert witness in education under G.S. 8C-1, Rule 702. Mr. Lewis' expert opinion
was that Petitioner could continue to be effective as a teacher and coach in some other community but probably not in the
Brunswick County community.
18. Carlton Prince has served for thirty years in the Whiteville, North Carolina City Schools, serving as principal for
the last fifteen before retiring in 1991. Mr. Prince was tendered and accepted as an expert witness in education under G.S.
8C-1, Rule 702. Petitioner served as a teacher, coach, and athletic director for a number of years at Whiteville while Carlton
Prince was the principal there. Mr. Prince gave an expert opinion that Petitioner still could effectively function as a teacher,
coach, athletic director, and role model for students.
19. Coleman Barbour has been in education for twenty-one years. He presently serves as principal at Whiteville High
School and was there during part of Petitioner's tenure as a teacher, coach, and athletic director. Mr. Barbour was tendered
and accepted as an expert witness in education and in middle and high school principalship under G.S. 8C-1, Rule 702. Mr.
Barbour gave an expert opinion that Petitioner still could function effectively as a teacher, coach, and as a role model in
middle or high school.
20. Joseph Miller has been in education for twenty-two years with the New Hanover County schools. He has known
Petitioner for approximately ten years in his capacities as football coach and athletic director. Mr. Miller was tendered and
accepted as an expert witness in teaching health and physical education at the high school level under G.S. 8C-1, Rule 702.
Mr. Miller gave an expert opinion that Petitioner still could function effectively as a teacher in health and physical education
and could continue to serve as a role model for students enrolled in his health and physical education courses.
21. Timothy Fitzgerald has been a teacher and assistant football coach at SBHS for the last five years. He served as
assistant football coach under the supervision of Petitioner for four of his five years at SBHS. Prior to that he was a teacher
and coach at West Brunswick High School. He served as a teacher and coach in six different schools in Ohio before coming
to North Carolina. He is certified to teach health and physical education, vocational welding, and history in North Carolina.
He was tendered and accepted as an expert witness in teaching health and physical education, vocational welding, and history
under G.S. 8C-1, Rule 702. Mr. Fitzgerald gave an expert opinion that Petitioner still could function effectively as a
teacher in health and physical education in high school and could continue to serve as a role model for students in his classes.
22. Petitioner was well regarded in the Brunswick County community prior to the November 1993 allegations. He
10:2 NORTH CAROLINA REGISTER April 17, 1995 182
CONTESTED CASE DECISIONS
continues to have a good reputation as a teacher and coach among those with whom he has worked during his teaching and
coaching career.
23. Petitioner's professional effectiveness in the Brunswick County community has been adversely affected by the events
of November 16, 1993, the subsequent investigation, and the resulting legal and administrative proceedings and press
coverage.
24. Public school teachers in North Carolina are required by statute to maintain discipline and to encourage temperance
and morality among students. N.C. Gen. Stat. Section 115C-307(6) (1994).
25. Our courts have enumerated various professional functions of teachers including, but not limited to,
(a) teaching subject matter,
(b) class discipline,
(c) interaction with the fellow staff members and administrative superiors,
(d) interaction with parents and community members, and
(e) interaction with and being a role model for students. Burrow v^ Board of Education. 61 N.C. App. 619,
625, 301 S.E.2d 704 (1983) (dismissal upheld where board found teacher no longer effectively could
perform enumerated professional functions).
CONCLUSIONS OF LAW
Based upon the foregoing Findings of Fact, I make the following Conclusions of Law.
1. The parties are properly before the Office of Administrative Hearings.
2. Respondent gave Petitioner constitutionally sufficient notice of the charges against him in the January 27, 1994
FINDING OF REASONABLE CAUSE AND STATEMENT OF CHARGES. Although Respondent indicated its intent to
proceed against Petitioner's certificate on the basis of its conduct rule, N.C. Admin. Code tit. 16, r.
6C.0312(a)(8)(November 1994), it also notified Petitioner of the underlying conduct and resultant pending criminal charges
and that the rule, 6C.0312, governed suspension and revocation of certificates.
3. Respondent has not defined the term conviction as used in its rules. Our Court has recited, with implicit approval,
a general rule for defining and applying the term conviction in a driver license revocation case:
[i]n the restricted or technical legal sense in which it is sometimes used, conviction means the final consummation
of the prosecution against the accused including the judgment or sentence rendered pursuant to a verdict, confession,
or plea of guilty. Frequently the term is used to denote the judgment or sentence itself, or to signify both the
ascertaining of the guilt of accused and judgment thereon by the court. A judgment or sentence is indispensable
to a conviction in this sense of the term, and the mere ascertainment of guilt by verdict or plea, which satisfies the
ordinary legal definition of conviction, does not suffice. In construing the term conviction, it has been held that
the technical meaning ought not to be attributed to it, unless there is something in the context to indicate that it was
used in such sense. Barbour y_, Scheidt , 246 N.C. 169, 173, 97 S.E.2d 855 (1957) (conviction for speeding with
prayer for judgment continued not conviction for purpose of driver license revocation because G.S. 20-24(c) then
required final conviction), citing. 24 C.J.S. Criminal Law, Section 1556, Page 17, in accord, Florence v^ Hiatt ,
101 N.C.App. 539, 400 S.E.2d 118 (1991).
4. Petitioner's conviction by a district court judge on June 3, 1994 of the criminal offense of assault on a female over
the age of eighteen is a conviction within the ordinary legal definition of the term and is a conviction within the contemplation
of N.C. Admin. Code tit. 16, r. 6C. 03 12(a)(3) (November 1994) which does not define or qualify the term so as to require
its use in the restricted or technical sense.
5. Respondent produced no evidence of the underlying conduct, from the November 16, 1993 incident, to support its
charge under N.C. Admin. Code tit. 16, r. 6C.03 12(a)(8) (November 1994), its other illegal, unethical, or lascivious conduct
rule. Respondent contends that it can proceed against Petitioner's certificate under its conduct rule, without producing
evidence of his conduct on November 16, 1993, solely by establishing his conviction on June 3, 1994.
To support this argument, Respondent asserts that Petitioner is estopped to relitigate issues determined in the
criminal trial. Application of collateral estoppel or res judicata in a subsequent action requires that the initial action result
183 NORTH CAROLINA REGISTER April 17, 1995 10:2
CONTESTED CASE DECISIONS
in a final, appealable judgment. State v^ Lewis , 311, N.C. 727, 319 S.E.2d 145 (1984) (defendant's criminal conviction,
with final judgment entered, for willful neglect of and refusal to support his minor children estops him from relitigating issue
of paternity in subsequent civil action); But see. Smith y^ Burden . 31 N.C.App. 145, 228 S.E.2d 662 (1976) (defendant,
pleading not guilty, found guilty with prayer for judgment continued in criminal action for nonsupport and paternity not
estopped from litigating issue of paternity in subsequent civil action because there was been no judicial determination (final
judgment) of paternity).
It is concluded as a matter of law that Respondent cannot rely solely on proof of Petitioner's conviction with a
prayer for judgment continued in the criminal action for assault on a female to prove the underlying conduct required to
sustain its charge of other illegal, unethical, or lascivious conduct in the present administrative action against Petitioner's
teaching certificate. Id.
6. Respondent must establish, by the greater weight of the evidence, not only that Petitioner has been convicted of a
crime as an adult, which it has done, but also that there is a reasonable and adverse relationship between the underlying
crime and the continuing ability of Petitioner to perform any of his professional functions in an effective manner. N.C.
Admin. Code tit. 16, r. 6C.03 12(a)(3) (November 1994).
7. Five expert witnesses testified that Petitioner still could function effectively as a teacher, coach, and role model for
students. Respondent called no expert witnesses to establish a reasonable and adverse relationship between Petitioner's
conviction of assault on a female over the age of eighteen and his continuing ability to perform any of his professional
functions in an effective manner. Considering the evidence thus produced in this contested case hearing, and the illustrative,
enumerated functions found in Burrows , supra , it is concluded as a matter of law that there is a reasonable and adverse
relationship between Petitioner's conviction for assault on a female over the age of eighteen and his continuing ability to
perform his professional functions in an effective manner in the Brunswick County community.
The preponderance of evidence in this contested case has established that Petitioner likely retains the ability to
perform his professional functions in an effective manner in some community in North Carolina other than the Brunswick
County community.
RECOMMENDED DECISION
Based upon the foregoing findings of fact and conclusions of law, it is hereby recommended that Respondent
determine, from the evidence admitted in this contested case hearing, the appropriate discipline, if any, which should be
applied to Petitioner under the circumstances of this case but that Respondent rescind its intent to permanently revoke
Petitioner's teaching certificate as not supported by a preponderance of the evidence or by substantial evidence.
ORDER
It is hereby ordered that the agency serve a copy of the final decision on the Office of Administrative Hearings, P.O.
Drawer 27447, Raleigh, N.C. 27611-7447, in accordance with North Carolina General Statute 150B-36(b).
NOTICE
The agency making the final decision in this contested case is required to give each party an opportunity to file
exceptions to this recommended decision and to present written arguments to those in the agency who will make the final
decision. G.S. 150B-36(a).
The agency is required by G.S. 150B-36(b) to serve a copy of the final decision on all parties and to furnish a copy
to the parties' attorney of record and to the Office of Administrative Hearings.
The agency that will make the final decision in this contested case is the North Carolina State Board of Education.
This the 31st day of March, 1995.
Beecher R. Gray
Administrative Law Judge
10:2 NORTH CAROLINA REGISTER April 17, 1995 184
CONTESTED CASE DECISIONS
STATE OF NORTH CAROLINA
COUNTY OF HYDE
IN THE OFFICE OF
ADMINISTRATIVE HEARINGS
95 EHR 0140
HOWARD C. SLACK,
Petitioner,
NORTH CAROLINA COASTAL
RESOURCES COMMISSION and
NORTH CAROLINA DEPARTMENT OF
ENVHIONMENT, HEALTH, AND
NATURAL RESOURCES,
Respondent.
ORDER OF DISMISSAL
FINAL DECISION AS TO
PETITIONER
THIS MATTER coming on to be heard by the undersigned Administrative Law Judge upon Respondent's Motion
to Dismiss; and the undersigned having reviewed the documents submitted by the parties and the law, makes the following:
FINDINGS OF FACT
1 . The petition which commenced this contested case was filed with the Office of Administrative Hearings
on February 8, 1995.
2. For the reasons stated in the petition, the Petitioner was dissatisfied with a decision by the Respondent to
grant a CAMA minor development permit to his neighbor to build a pier on what he believed to be his property.
3. On February 8, 1995, the Petitioner also filed a "Third Party Hearing Request on CAMA Permit Decision"
with the Coastal Resources Commission as required by G.S. 1 13A-121 . 1(b) in order to request a determination of the
appropriateness of a contested case hearing.
4. At the time of the filing of the petition for a contested case hearing with the Office of Administrative
Hearings, the Third Party Request had not been ruled on by the Coastal Resources Commission.
5. As stated in the Respondent's Motion to Dismiss and as shown in Exhibit 2 of Petitioner's Response to
Motion to Dismiss, on February 23, 1995, the Respondent's counsel advised the Petitioner's counsel by letter that the
Chairman of the Coastal Resources Commission, Mr. Eugene Tomlinson, had denied the Petitioner's hearing request.
Based upon the foregoing Findings of Fact, the undersigned makes the following:
CONCLUSIONS OF LAW
1 . Upon a forecast of evidence provided by the parties, the Petitioner would meet the definition of a "person
aggrieved" as provided in G.S. 150B-2(6); however, the organic statute, Article 7 of Chapter 113A entitled Coastal Area
Management Act ("CAMA"), provides a specific exception to the general provisions of the N.C. Administrative Procedure
Act for dissatisfied third parties. G.S. 1 13A-121. 1(b).
2. G.S. 1 13A-121 . 1(b) provides that a third party who is dissatisfied with a decision to grant a minor
development permit may file a petition for a contested case hearing "only if the Coastal Resources Commission determines
that a hearing is appropriate. "
3. At the time that the petition was filed on February 8, 1995, the Coastal Resources Commission had not
made a decision regarding the appropriateness of a hearing as required by G.S. 1 13A-121. 1(b). Therefore, this contested
case was not ripe for review at the time the petition was filed.
785
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CONTESTED CASE DECISIONS
I
4. Even if a decision had been made at the time the petition was filed with the Office of Administrative
Hearings, the organic statute provides that a decision by the Coastal Resources Commission denying the third party request
for a contested case hearing is a final agency decision and the person aggrieved by such final agency decision is entitled to
judicial review in superior court pursuant to Article 4 of Chapter 150B of the North Carolina General Statutes. G.S. 113A-
121.1(b); see also, G.S. 113A-123(a) & (b).
5. Once the Petitioner receives the written order from the Coastal Resources Commission denying his request
to commence a contested case, he will have thirty days in which to file a petition for judicial review in superior court. G.S.
150B-45. Therefore, he maintains an opportunity to redress his grievance.
6. Based upon Empire Power Co. y^ N.C. Dept. of E.H.N.R. , 337 N.C. 569, 447 S.E.2d 768 (1994), the
Office of Administrative Hearings does not have subject matter jurisdiction to hear this matter; however, this conclusion of
law is made without prejudice to the Petitioner should the superior court determine upon judicial review of the denial of
Petitioner's Third Party Hearing Request that he was entitled to a contested case hearing.
IT IS THEREFORE ORDERED that the Respondent's Motion to Dismiss this petition based upon a lack of subject
matter jurisdiction is hereby ALLOWED and this contested case must be and is hereby DISMISSED WITHOUT
PREJUDICE. This is a final decision pursuant to G.S. 150B-36(c).
NOTICE
This final decision is subject to judicial review in the Superior Court Division of the North Carolina General Court
of Justice in accordance with the provisions of G.S. Chapter 150B, Article 4, which require that an appeal be filed in the
superior court within thirty (30) days following service upon the person of a written copy of the final decision.
This the 22nd day of March, 1995.
Meg Scott Phipps
k Administrative Law Judge
1
I
10:2 NORTH CAROLINA REGISTER April 17, 1995 186
NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM
1 he North Carolina Administrative Code (NCAC) has four major subdivisions of rules. Two of these, titles and
chapters, are mandatory. The major subdivision of the NCAC is the title. Each major department in the North
Carolina executive branch of government has been assigned a title number. Titles are further broken down into
chapters which shall be numerical in order. The other two, subchapters and sections are optional subdivisions
to be used by agencies when appropriate.
TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE
TITLE DEPARTMENT LICENSING BOARDS CHAPTER
1
Administration
Acupuncture
1
2
Agriculture
Architecture
2
3
Auditor
Auctioneers
4
4
Commerce
Barber Examiners
6
5
Correction
Certified Public Accountant Examiners
8
6
Council of State
Chiropractic Examiners
10
7
Cultural Resources
General Contractors
12
8
Elections
Cosmetic Art Examiners
14
9
Governor
Dental Examiners
16
10
Human Resources
Dietetic s/Nutrition
17
11
Insurance
Electrical Contractors
18
12
Justice
Electrolysis
19
13
Labor
Foresters
20
14A
Crime Control & Public Safety
Geologists
21
15A
Environment, Health, and Natural
Hearing Aid Dealers and Fitters
22
Resources
Landscape Architects
26
16
Public Education
Landscape Contractors
28
17
Revenue
Marital and Family Therapy
31
18
Secretary of State
Medical Examiners
32
19A
Transportation
Midwifery Joint Committee
33
20
Treasurer
Mortuary Science
34
♦21
Occupational Licensing Boards
Nursing
36
22
Administrative Procedures
Nursing Home Administrators
37
23
Community Colleges
Occupational Therapists
38
24
Independent Agencies
Opticians
40
25
State Personnel
Optometry
42
26
Administrative Hearings
Osteopathic Examination & Reg. (Repealed)
44
Pharmacy
46
Physical Therapy Examiners
48
Plumbing, Heating & Fire Sprinkler Contractors
50
Podiatry Examiners
52
Professional Counselors
53
Practicing Psychologists
54
Professional Engineers & Land Surveyors
56
Real Estate Appraisal Board
57
Real Estate Commission
58
Refrigeration Examiners
60
Sanitarian Examiners
62
Social Work Certification
63
Speech & Language Pathologists & Audiologists
64
Therapeutic Recreation Certification
65
Veterinary Medical Board
66
Note: Title 21 contains the chapters of the various occupational licensing boards.
757
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CUMULATIVE INDEX
Agency/Rule Citation
Proposed in
Register
Proposed
Effective
Date
Fiscal Note
State Local
Effective
Date
Other Information
ACUPUNCTURE LICENSING BOARD
21 NCAC 01
.0101
10:02 NCR
150
07/01/95
.0401 -
.0402
10:02 NCR
150
07/01/95
CORRECTION
5 NCAC 05
.0001
10:01 NCR
12
07/01/95
CULTURAL RESOURCES
7 NCAC 02F
.0002
10:01 NCR
12
07/01/95
ENVIRONMENT
, HEALTH, AND NATURAL RESOURCES
15A NCAC 02B
.0101
.0104
.0202
.0211
.0301
10:01 NCR
10:01 NCR
10:01 NCR
10:01 NCR
10:01 NCR
13
13
13
13
13
02D
.0520
10.01 NCR
13
07/01/95
X
X
.0531
10:01 NCR
13
07/01/95
X
X
.0902
10:01 NCR
13
07/01/95
X
X
.0909
10:01 NCR
13
07/01/95
X
X
.0952
10:01 NCR
13
07/01/95
X
X
.1402
10:01 NCR
13
07/01/95
X
X
.1406
10:01 NCR
13
07/01/95
X
X
.1409
10:01 NCR
13
07/01/95
X
X
.1701 -
.1702
10:01 NCR
13
07/01/95
X
X
.1801 -
.1803
10:01 NCR
13
07/01/95
X
X
NPDES Permit
10:02 NCR
56
04B
.0028
10:02 NCR
149
07/01/95
10B
.0202-
.0203
10:01 NCR
26
07/01/95
.0214
10:01 NCR
26
07/01/95
10D
.0002-
.0003
10:01 NCR
26
07/01/95
10F
.0317
10:01 NCR
26
07/01/95
Wildlife Proclamation/Stripec
Bass
10:02 NCR
57
04/10/95
FINAL DECISION LETTERS
Voting Rights Act
10:01 NCR
02
Correction to Notice
Correction to Notice
Correction to Notice
Correction to Notice
Correction to Notice
GOVERNOR'S EXECUTIVE ORDERS
Number 72 10:01 NCR 01
Number 73 10:02 NCR 54
Number 74 10:02 NCR 54
03/06/95
03/15/95
03/27/95
HUMAN RESOURCES
10 NCAC 03H
.0108 -
.0109
10:02 NCR
58
09/01/95
.0206-
.0220
10:02 NCR
58
09/01/95
.0306-
.0318
10:02 NCR
58
09/01/95
.0407-
.0409
10:02 NCR
58
09/01/95
.0505 -
.0507
10:02 NCR
58
09/01/95
.0510 -
.0517
10:02 NCR
58
09/01/95
.0605 -
.0609
10:02 NCR
58
09/01/95
.0705 -
.0712
10:02 NCR
58
09/01/95
.0810 -
.0812
10:02 NCR
58
09/01/95
.0903 -
.0911
10:02 NCR
58
09/01/95
.1003 -
.1008
10:02 NCR
58
09/01/95
.1105 -
.1109
10:02 NCR
58
09/01/95
.1130-
.1136
10:02 NCR
58
09/01/95
.1150-
.1163
10:02 NCR
58
09/01/95
.1204-
.1208
10:02 NCR
58
09/01/95
.1210
10:02 NCR
58
09/01/95
.1306-
.1308
10:02 NCR
58
09/01/95
.1405 -
.1406
10:02 NCR
58
09/01/95
10:2
NORTH CAROLINA REGISTER
April 17, 1995
188
CUMULATIVE INDEX
Proposed
Effective
Other Information
Proposed in
Fiscal note
Agency /Rule Citation
Register
Effective
Date
State
Local
Date
.1408 -
.1410
10:02 NCR
58
09/01/95
.1501 -
.1503
10:02 NCR
58
09/01/95
.1612 -
.1613
10:02 NCR
58
09/01/95
.1703 -
.1704
10:02 NCR
58
09/01/95
.1804 -
.1807
10:02 NCR
58
09/01/95
.2001
10:02 NCR
58
09/01/95
.2101 -
.2110
10:02 NCR
58
09/01/95
.2201 -
.2212
10:02 NCR
58
09/01/95
.2301 -
.2308
10:02 NCR
58
09/01/95
.2401 -
.2402
10:02 NCR
58
09/01/95
.2501 -
.2506
10:02 NCR
58
09/01/95
.2601 -
.2607
10:02 NCR
58
09/01/95
.2701
10:02 NCR
58
09/01/95
.2801 -
.2802
10:02 NCR
58
09/01/95
.2901 -
.2902
10:02 NCR
58
09/01/95
.3001 -
.3005
10:02 NCR
58
09/01/95
.3011 -
.3016
10:02 NCR
58
09/01/95
.3021 -
.3032
10:02 NCR
58
09/01/95
.3101 -
.3104
10:02 NCR
58
09/01/95
.3201 -
.3202
10:02 NCR
58
09/01/95
.3301 -
.3302
10:02 NCR
58
09/01/95
.3401 -
.3404
10:02 NCR
58
09/01/95
18J
.0803
10:02 NCR
118
07/01/95
26B
.0124
10:02 NCR
118
07/01/95
26H
.0213
10:02 NCR
118
07/01/95
JUSTICE
12 NCAC 09A
.0204
10:02 NCR
122
08/01/95
09B
.0113
10:02 NCR
122
08/01/95
.0201 -
.0202
10:02 NCR
122
08/01/95
.0205 -
.0206
10:02 NCR
122
08/01/95
.0210
10:02 NCR
122
08/01/95
.0212 -
.0214
10:02 NCR
122
08/01/95
.0226 -
.0228
10:02 NCR
122
08/01/95
.0232 -
.0233
10:02 NCR
122
08/01/95
09C
.0401
10:02 NCR
122
08/01/95
.0601
10:02 NCR
122
08/01/95
09D
.0102
10:02 NCR
122
08/01/95
.0104-
.0106
10:02 NCR
122
08/01/95
LABOR
13 NCAC
10:01 NCR
10
01/01/96
10:01 NCR
12
01/01/96
10:02 NCR
149
10/01/95
10:02 NCR
149
01/01/96
10:02 NCR
149
01/01/96
10:02 NCR
149
02/01/96
12
.0101
10:02 NCR
142
08/01/95
.0303 -
.0315
10:02 NCR
142
08/01/95
.0501 -
.0502
10:02 NCR
142
08/01/95
.0803 -
.0808
10:02 NCR
142
08/01/95
LIST OF RULES CODIFIED
10:02 NCR
167
MEDICAL EXAMINERS
21 NCAC 32H
.0102
10:02 NCR
151
07/01/96
.0201
10:02 NCR
151
07/01/96
.0203
10:02 NCR
151
07/01/96
.0408
10:02 NCR
151
07/01/96
.0506
10:02 NCR
151
07/01/96
.0601
10:02 NCR
151
07/01/95
.0602
10:02 NCR
151
07/01/96
.0801
10:02 NCR
151
07/01/96
Notice on Subject Matter
Notice on Subject Matter
Notice on Subject Matter
Notice on Subject Matter
Notice on Subject Matter
Notice on Subject Matter
Rules Filed 03/95
189
NORTH CAROLINA REGISTER
April 17, 1995
10:2
CUMULATIVE INDEX
Agency/Rule Citation
Proposed in
Register
Proposed
Effective
Date
Fiscal Note
State Local
Effective
Date
Other Information
32H .1001
321 .0003 - .0004
10:02 NCR
10:02 NCR
151
151
07/01/96
07/01/95
PLUMBING, HEATING & FIRE SPRINKLER CONTRACTORS
21 NCAC 50 .0402 10:01 NCR 39 09/01/95
.0505 10:01 NCR 39 09/01/95
PROFESSIONAL COUNSELORS
21 NCAC
53 .0204 -
.0211
10:01 NCR
40
07/01/95
.0301
10:01 NCR
40
07/01/95
.0305 -
.0310
10:01 NCR
40
07/01/95
.0403 -
.0405
10:01 NCR
40
07/01/95
.0601 -
.0604
10:01 NCR
40
07/01/95
REAL ESTATE COMMISSION
21 NCAC
58A .0110
10:02 NCR
157
07/01/95
.0504-
.0506
10:02 NCR
157
07/01/95
.1703
10:02 NCR
157
07/01/95
.1707 -
.1708
10:02 NCR
157
07/01/95
.1710-
.1711
10:02 NCR
157
07/01/95
58E .0103
10:02 NCR
157
07/01/95
.0203 -
.0204
10:02 NCR
157
07/01/95
.0303 -
.0305
10:02 NCR
157
07/01/95
.0406-
.0407
10:02 NCR
157
07/01/95
.0506
10:02 NCR
157
07/01/95
.0515
10:02 NCR
157
07/01/95
REVENUE
Tax Review Board
10:01 NCR
03
10.2
NORTH CAROLINA REGISTER
April 17, 1995
190
I
♦
<
BARCLAYS OFFICIAL
NORTH CAROLINA ADMINISTRATIVE CODE
The full Barclays Official North Carolina Administrative Code consists of 22 volumes, totaling in excess of
10,000 pages. It is supplemented monthly with replacement pages. A one year subscription to the full
publication, including supplements, can be purchased for seven hundred and fifty dollars ($750.00).
Individual volumes may also be purchased with supplement service. Renewal subscriptions for supplements
to the initial publication are available at one-half the new subscription price.
PRICE LIST FOR THE SUBSCRIPTION YEAR
Volume
Title
Chapter
New Total
Subject Subscription* Quantity Price
1 -22
Full Code
1
2
2
3
4
4
5
5
6
7
8
9
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
11
12
13
13
13
14A
15A
15A
15A
15A
15A
1 -39
1 -24
25-53
1 -4
1 -2
3 -20
1 -2
3 -4
1 -4
1 - 12
1 -9
1 -4
I -2
3A-3K
3L-3R
3S -3W
4-6
7
8-9
10
II - 14
15 - 17
18
19-30
31 -33
34-41
42
43 -51
1 - 19
1 - 12
1 -6
7
8- 16
1 - 11
1 -2
3 -6
7
8 -9
10
All titles
Administration
Agriculture
Agriculture
Auditor
Commerce (includes ABC)
Commerce
Correction
Correction
Council of State
Cultural Resources
Elections
Goveraor/Lt. Governor
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Human Resources
Insurance
Justice
Labor
OSHA
Labor
Crime Control and
Public Safety
EHNR (includes EMC)
EHNR
Coastal Management
EHNR
Wildlife
$750.00
1
$90.00
2
$75.00
2
$75.00
2
$10.00
3
$45.00
4
$90.00
5
$60.00
5
$30.00
5
5
$30.00
$60.00
6
$10.00
6
$45.00
7
$30.00
7
$90.00
7
$45.00
7
$30.00
8
$30.00
8
$30.00
8
$30.00
8
$30.00
8
$60.00
8
$45.00
9
$75.00
9
$90.00
10
$30.00
10
$60.00
11
$45.00
11
$90.00
12
$90.00
13
$90.00
14
$30.00
14
$45.00
14
$45.00
14
$45.00
15
$90.00
15
$45.00
15
$45.00
16
$30.00
16
$45.00
Volume
Title
Chapter
New Total
Subject Subscription* Quantity Price
16
15A
15A
16
17
17
18
19A
20
21
21
21
22
23
24
25
26
11-18 EHNR
19 - 26 EHNR
(includes Breathalizer)
1 - 6 Education
1-6 Revenue
7-11 Revenue
1 - 8 Secretary of State
1-6 Transportation
1-9 Treasurer
1-16 Licensing Boards
17-37 Licensing Boards
38-70 Licensing Boards
(repealed) Administrative Procedures
1-3 Community Colleges
1-5 Independent Agencies
1 State Personnel
1-4 Administrative Hearings
Binders (1 binder per item ordered)
Shipping & Handling (per item ordered)
(entire code)
<
(North Carolina sales
$90.00
17
$75.00
18
$30.00
18
$75.00
18
$60.00
19
$30.00
19
$90.00
19
$45.00
20
$75.00
20
$75.00
21
N/A
$60.00
N/A
$10.00
22
22
$10.00
22
$60.00
22
$10.00
$16.00
i $4.50
$85.00
Subtotal
tax 6%)
Total
(Make checks payable to Barclays Law Publishers)
* This price includes the title in its current form plus supplementation for the subscription year.
Mail To:
Name
BARCLAYS LAW PUBLISHERS
P.O. BOX 3066 Address
SOUTH SAN FRANCISCO, CA 94083-3066
Room/Suite
Phone: (800) 888-3600
Fax: (415) 244-0408 City State Zip
Phone Number
If Credit Card Order:
□ VISA □ Master Card □American Express
Credit Card Number Exp. Date
Signature
I
CHANGE OF ADDRESS
1. Present Address
NAME
ADDRESS
CITY
STATE
ZIP
2. New Address
NAME
ADDRESS
CITY
STATE
ZIP
Office of Administrative Hearings
P.O. Drawer 27447
Raleigh, North Carolina 27611-7447
US. PC5TAGE*|
-
10 *l
FIRST CLASS MAIL
565
UNIV. OF NORTH CAROLINA
LAW LIBRARY CB# 3335
m HECKE-UETTACH 064-6
CHAPEL HILL
NC 27599
TVNews
OpenLibrary